Upping dose or changing

Treatment and medication
1

Hi All. Thanks for everyone's amazing responses and support the last few weeks. I am currently mid week 7 of full dose (20mg). I was started on 5mg for 4 days then I was on 10mg for 2 weeks, but I am not counting those weeks now. Should I be?

My psychiatrist has been seeing me weekly because I have had such a crazy time with side effects, but she is away now and I only see her again on the 19th.

Worst side effects are severe increase in anxiety (although I can manage a panic attack before it happens better now than before), jitteriness, especially in the morning and during the day, insomnia (no problem falling asleep but still waking up most mornings at 4:30 despite taking ambien 10mg) and worse depression. But I think that the depression is just because I was finally diagnosed and accepted it, so perhaps more the illness than the medication.

My depression was caused by years of untreated anxiety, thats my own two cents. Also struggling with obsessional thoughts and mind racing which is like torture.

Yesterday I had an awful day, very anxious and jittery all day, and I can usually calm down at night but last night I couldnt and I took 0.25 of Alzam which sorted me out.

Most days have been severe low mood and anxiety at the same time, and new side effects include an upset tummy (why now?) and my appetite has gone down slightly.

But I must say, the day before yesterday I had an ok day, and today I am having an ok day. I feel a bit flat but not too panicked and bad.

I guess my question is, is 8.5 weeks on 20mg (that is where I will be when I see my psychiatrist) long enough to see the full benefits or should I just bite the bullet and try to get to 12 weeks?

I am terrified to either up my dose to 40mg (that is what my doc will do first, before considering changing to Sertraline).

But I would rather go through another 4 weeks of this than have the potential of having to start on a new drug or double my dose which I think will make my anxiety much worse.

Has anyone had a good effect on their anxiety once upping the dose from 20 to 40mg? I am not off work so I need to be functional.

Hope everyone else is doing well and that those that have been on the meds for longer than 6 months can give some positive input.

 

2

Hey . I'm the exact same as you describe yourself to be and am on 7 weeks at 20mg and still have anxiety etc etc and obsessional thoughts however I think the best option is to continue to twelve weeks . I have experience of trying sertraline and had a very bad reaction to it which gave me a huge ginormous panic attack I never had before ! And I suffer from panic attacks regularly but this was extreme . The other options are antipsychotics which I would not recommend due to terrible side effects . I have also tried lexapro and it is not great either gave me akathesia . I think u should stick with prozac I feel the exact same as u right now but I'm gonna give 20 mg 12 weeks at least ! Most people that have had success with this say at 15 weeks they feel resettled completely again so it takes time

3

I'm just over 5 weeks. I have all the same side effects. Reading what others have said on this site it can take some people up 12 weeks to start seeing a difference. I'm trying to hold and think positive. I know easier said than done especially when the anxiety is high. When I'm suffering with high anxiety, nausea and the shakes, I find I feel more depressed. It's easy to when you feel physically crappy.

I hope things start getting better for you soon.

Its a long road it's seems to mental health, so try and take it one day at a time.

Be kind to, and take care of yourself.

4

Hiya... well done for sticking this out. Improvement is 1 step forward and 28 steps backwards but it slowly gets there. Do not count your first weeks as anything the dose was to small to be of anything important. Start counting from the 20mg. I increased to 30mg around the 8 week mark and then 40mg around 10 days later. The only side effects I felt from going up to 30mg was the sleep playing up again and a bit of insomnia but not nothing major. When I went up to 40mg I had more of the side effects again and around week 3 of that some anxiety but it did not last for very long maybe a few really not so good days. I have no idea why people are so paranoid about increasing... yes be paranoid about starting something new but you know the medication now.. you know what side effects to expect and you know you are strong enough to handle them. I have been on 40mg for about 8 months now total and feel great. It took its time but now I sleep well... have no anxiety... no horrible thoughts and live my life like normal. 20mg was not enough juice for me and I knew it would not be from the start. If you do an increase then maybe even ask to go up to 30mg for 4 weeks or something like that and cut the tablets in half with a pill cutter. You got this.

5

Question - so when I took the 10 mg for two weeks and now 20 mg for six weeks I shouldn't really count the 10 mg for two weeks since it was a low dose?    I am afraid to go up to 30 or 40 since I am 5'7" and now weigh 122 pounds.  Afraid it will be too much for my system.  But not sure.

6

I think of the 10mg as nothing basically... just a way to slowly introduce the medication into your body. My Doctor never counted that as anything at all with my amount of weeks.

I lost weight as well and I was happy about that... but the appetite did return and returned really well after a while! I just forced myself to eat.. took some vitamin tablets.. if I struggled to eat then I had some soup or a smoothie with banana, berries, spinach or kale, yogurt and milk or something which I could drink and still get some calories in to me. But now I am back to eating properly again which is kind of annoying as I needed that weight loss

7

HI Lookingonwards, thank you so much for your words of encouragement. Yesterday was my best day in a few weeks but the sleeping is creating havoc on my mood I think. Last night I went to sleep at 11 pm and slept until 3:45. I then took half an ambien which didnt do anything, and ended up dozing for another hour. So feeling it today. But luckily its Friday I will have to stay the course until my doc is back and then go from there but holding thumbs the good days start increasing now on. Yes I think if we do up the dose I will definitely start on 30mg. 

Thanks so much, and glad to hear you are doing so well 8 months in. When did you start feeling much better? 

8

Hiya,

I started feeling way way better at close to the 7 month mark... it takes time and the side effects start going one by one but it is not a quick fix and patience is needed. What time of day are you taking your tablets?

 

9

Wow I cant imagine waiting that long to feel better. When I started I took it in the morning but initial side effects made me very drowsy so I changed it to evening. I take it anywhere between 7 and 10;30 pm. You? Not sure if this is making my insomnia worse but looking back on my journal entries, it was the same when I was taking it in the morning. 

Also feeling an odd sense of detachment from other people from time to time, and it really bugs me, especially when it comes to my loved ones. Perhaps the meds or a symptom of the depression.

10

I was feeling better but still have the occasonal off day here or there... 

I take mine at night around 8.00pm but I also work evenings. But I also had the same issue... very tired after taking the tablets but about 5 hours later wide awake!!