Medication

Hello again Sillymop

It's definitely the most stressful thing you can do. Our last house purchase fell through on the day of exchange which left us with a week to find somewhere to move to. Very difficult time and that's when all this anxiety / stress starterd. 2nd time lucky eh.

I think I need something for a couple of months just to get a break from it all. I have a plan to tackle my issues (my job is a massive driver) but my body just can't handle the stress without producing an unjustified reaction. I went for a job interview last week and could barely talk without stopping for a breath. Usually you can't shut me up haha!

I am not keen on antidepressants either and it's a very last resort but starting to think what if they help and I am just being stupid worrying about side effects. They do say it's a trail and error type medication which isn't re-assurring.

It doesn't help getting conflicting information either.

How have you been?

I am a little better I find my anxiety really upsets my vision, which causes more anxiety. I had a GP appointment a few days ago and laid all my cards on the table and didn't shy away from mentioning any symptoms. I was still told it was anxiety so I'm continuing forward now even when I have bad days.

Anxiety medication are called SSRI's. This stands for selective serotonin reuptake inhibitors. They work on mood levels and balance them by altering chemical levels within the brain and disallowing for certain behaviours to kick in. They really helped me while I was on them which was well over ten years.

What they don't tell you however is that none are wonder drugs. If you are experiencing stress in life such as work (or house moving!) you will still be made to feel anxious by these events. Anxiety is an emotion and they do not switch it off.

Instead they can make it more manageable (unless the stress is too severe and then they up your dosage - possibly.)

Also. No SSRI is short term. Each with give withdrawals, including Prozac (a relative tried to come off them and was very ill.)

They are for long term use and to be taken in conjunction with therapy.

I disagree with any GP who says otherwise.

When you come off medication one withdrawal symptom is for your anxiety/depression (or both,) to worsen for a short time.

If you find they help you it may be within your interest to stay on them until your life's stresses becomes manageable: so for arguments sake, after you have moved and settled into a new job.

You will then be able to choose when you are ready to come off and book time off work.

It's amazing just how many physical sensations this Anxiety can cause isn't it. I literally wrote all my symptoms down and asked the GP to read through the list - I usually go into the room a dizzy mess and forget half the stuff I wanted to mention!.  The good thing is I have accepted it’s just anxiety and no longer spend age’s googling what’s wrong.

He laughed and said it's all anxiety anyway and the good news is it will pass in time. It's situational and a crutch will probably help for the short term. Realistically I agree, if I started it then it probably would be a year or so at least until everything has worked out.

That was my worry with SSRI's in general though. Fluoxetine (Prozac) made me very ill for a good month. Constantly shakes, vomiting, no appetite, and insomnia, the list goes on. I stopped cold turkey to and just 2 months of horrible withdrawal symptoms. It felt like the worst flu I have ever had!

 How did you find that they helped the anxiety? I would expect the odd flair up but it’s the everyday part that’s the pain!

I took seroxat which I believe now is only given out in serious cases as the withdrawal from this is just terrible. my dosage had to be slowly lowered each month, then each week. By the time I was on 5mg (I took this every other day,) the withdrawal was at its worst.

Other SSRI's may not pack the same punch I expect, but even so you will still have to be weaned off your medication slowly. Someone I know managed it in a month, others it took a little longer.

You will also have to find the right medication for you and this is probably why I don't go back myself.

You will likely be prescribed Sertraline at first, but not everyone can take it (it made me feel SICK and decided I felt better when I was anxious.) This is the trial and error aspect - you will be put on meds and monitered. If they make you feel unwell or don't help they either wean you off and try another, or they will up the dosage.

Once you begin this journey it is difficult to get out off, which is why I say you need to give it time.

My day to day anxiety on my medication was better. I didn't feel constantly on edge but the anxiety was still there. I didn't 'feel' it and so it came out in other ways and for me it made my OCD worse.

My friend is on Sertraline and experiences hot sweats and itchy skin. She originally thought it was the medication, but found it was just her body having to release the emotions in a different way.

Once she had therapy and dealt with some

Of the causes, this lessened.

You mentioned that you had CBT? I did too but like you I didn't find it helped. What really changed things for me was counselling. If you find a good counsellor they are far, far more effective than any medication.

Hi! Is the doctor suggesting you take zoloft a GP or a psychiatrist?

The fact that you have already tried Prozac (fluoxetine) means this is not just situatiuonal but that you do have a background anxiety condition that flares up during times of heightened stress (positive and negative stress is still stress).

You are both absolutely right - there is no short-term therapy with antidepressants. There are doctors who prescribe them for short duration but these should have their licences revoked The amount of 'damage' done to the brain's response systems by jerking it around for a 6 month brisk 'supportive' therapy is substantial. And never justified.

Antidepressants need to be taken for a minimum couple of years to get full benefits and help the brain regroup while you work stuff out in therapy or through personal effort and experience. They are unable to fix the issue but aim to provide a backdrop conductive to recovery. They certainly have their place in therapy but this has to be done right.

The only alternative for the crutch you are mentioning is a 1-2 month short course of benzos for example lorazepam or alprazolam in small but regular daily doses to mellow you out and then a gentle taper until you are over the situation causing the current flare-up. You will find GPs do not prescribe these in such way and even psychiatrists will be aversive to offering this crutch and only occasionally humor and try it in those without prior history of depressive and anxiety disorders.

I think we have come a long way in terms of antidepressants and that in those with substantial problems they are well worth the hassle.

In cases like yours I am not sure why they would prescribe old school prozac which is quite a stimulant actually, or zoloft when they have the option of citalopram and escitalopram for example which will also help relax you? Is it a cost thing? Unless of course your doctor is a GP as I presume in which case my advice is to consult a competent psychiatrist on the best course of action and a proper asessment of the intensity of your issue.

All the best.

 

Oh and in this odd case...your dentist is right: ampitryline would potentially be a better bet than zoloft based on your symptoms! The best thing to do is get a second opinion - from a psychiatrist. Is that possible for you?

*amitriptyline

Thank you for your reply. It is very helpful.

I have no idea why I was prescribed Prozac. It genuinely seems to be a lucky dip as to which one the GP prefers! I have been prescribed Sertraline by 3 different doctors and one was a bit annoyed I hadn't tried it. When I explained I couldn’t yet due to needing to be physically able to move house, I was given mirtazapine which was useless. The sleep was amazing, but the raging appetite and sedation meant I literally just didn't do anything. I was sleeping for 15 hours+ a day and in work no amount of coffee could wake me. Safe to say I had to stop them.

At the time this flared up, I had no understanding of anxiety or what it was. Though the more I read into it, the more I realise I have had a lot of obvious symptoms, just never knew what to attribute it to.

Prozac was indeed a horrible experience and when I had taken it, I had lost close to 3 stone in weight beforehand (stress breakdown) so the side effects on top of being weak already were horrendous.

The GP doesn't feel that he can refer me to a psychiatrist until I at least try the first step which is Sertraline. I agree completely though, I wouldn't endure all the initial side effects only to come off them in 2 months’ time and taking them isn’t a decision I am taking lightly hence why they have sat in my drawer for a month while I make my mind up haha.

 I would probably need something long term. As Sillymop said, until the house is complete and I am settled into a new job and if I am stable on them, I wouldn’t see a reason to come off immediately. I can imagine it will do more damage to your nervous system / brain to start and stop on them!

It was more of a crutch to help lift the low mood a bit and give me more energy / confidence to get out of the place I know is coursing all my problems.

I could always try the amitriptyline for a few weeks and if doesn’t help move on?

I am also registered to start therapy again hopefully soon, so maybe that will work without the medication.

Fingers crossed. Thank you both for the support.

You could try Amitriptyline and see. However any medication will initially make you a little (or a lot) off. In most cases it is worth it however. make sure that whichever route you take you give it time and once the time comes to discontinue, you really take your time.