Reason meds take so long and why you feel rubbish
Posted , 33 users are following.
Hi everyone, here’s something I found online which you may find intersting. Its about why you feel so rubbish when taking these meds, why your mood is up and down, why it takes so long and the process it all goes through.
Sorry its a long post.
When starting an SSRI or increasing it's dose often makes people feel really rubbish, which can cause a great deal of stress as you begin to wonder whats happening, why is their illness getting worse, are these meds working etc.
Somone recently posted a great post explaining what these meds do in our brains, and I’d like to add further to this. So, as already posted ….. the brain is basically a big dense bundle of nerves which carry electrical signals around our brain and body. The nerve cells don’t touch each other, leaving a small gap between each cell, called a synapse. So how do signals get from one nerve to another?
Neurotransmitters are chemicals released by nerve cells that tell a neighbouring nerve cell to pass the signal along. A bit like pass the parcel. Serotonin is one such neurotransmitter. So when an electrical signal reaches the end of a nerve cell that deals with serotonin, that cell releases serotonin into the gap (synapse), which then crosses the gap and interacts with the nearby nerve cell and tells it to pass the signal along.
Once the serotonin has done it's job, the serotonin is then reabsorbed from the gap so that no more signals are passed until the next one comes down the nerve. SSRIs, (Selective Serotonin Reuptake Inhibitors) interfere with this reabsorbtion process and thus it stays in the gap longer, which equates to more serotonin and more signals.
So furthering on from there ….. why do you feel so rubbish?
So, along with the releasing of serotonin, and reabsorbing it, nerve cells also have parts that detect an increase in serotonin level and tell the nerve cell to stop producing anymore serotonin until the level drops. These are called autoreceptors, which are the reason you feel like so rubbish.
So the SSRI will increase the amount of serotonin that’s gathered in the synapses between nerve cells, but unfortunately the autoreceptors of the nerve cell pick up on this increase and tell the nerve cell to stop producing serotonin. The result of this is that when you first start taking an SSRI your serotonin levels drop.
How do they go up again?
Eventually with continuous use of the SSRI medication, the autoreceptors become desensitised, that is to say they've continually told the nerve cell to stop producing serotonin but yet serotonin is still there. In short they simply give up. They stop telling the nerve cell to stop producing serotonin and your serotonin levels start to increase.
This desensitisation takes time, it doesn't happen over night and it won't even begin to happen until the SSRI levels have stabilised. This is why you feel so rubbish, and is why your mood drops and your anxiety increases (also fuelledd by the fear of not knowing whats going on). Your mood will be up and down as the seronotin continues to try to stablise.
So, to summarise:
SSRIs cause your serotonin levels to drop when you first start taking them. Your serotonin levels will not rise until the autoreceptors in your brain have stopped working (become desensitised), all of which takes lots and lots of time. Everyone is different, so for some it can be many weeks and other months.
I hope this helps some people to understand what these meds are doing and why you don't get instant results, compared to other meds that work in different ways which is the reason they can have a more immediate effects (benzos for example).
K x
16 likes, 145 replies
CG55 katecogs
Posted
I also had to come off HRT recently and have been feeling quite anxious and not sleeping properly inspite of being on 10mg citalopram. I have been given Noumed brand of Citalopram recently (previously on Aurobindo which suited me well) which I have never had before and have a feeling this is the main issue. Have just phoned up 10 pharmacies and the majority seem to be only stocking Noumed for NHS prescriptions which is worrying. My Father (retired GP) says that the difference in the coating of the tablet really can make a huge difference to the way the body absorbs the medication. Have spoken to my gp and have found 2 pharmacies which stock other brands apart from Noumed so will go to one of those once prescription available. Never seen such a lack of supply of Citalopram brands available for NHS prescription, there has always been a choice of at least 2 brands. Wondering whether NHS has stipulated Noumed to suppliers because it is marginally cheaper than other generic brands, most other generic brands pretty cheap anyway so it must be a matter of pennies difference.
katecogs CG55
Posted
Hi
Yes different brands certainly do have different ingredients - I also always thought it was just the coating, but researched the 2 PL numbers I had before and find the core differs too (it has some same ingredients but are listed in a different order which I always assume mean a different quantity)?
The 2 brands I’ve had before are Sandoz and then Sovereign though I don’t recall noticing notice a difference. Lots of people do though.
It wouldn’t surprise me that the NHS would go for a cheaper option - I think price per pill ranges from .91p to .99p, which is .24p per packet, so hardly a difference.
I always made note of the PL number on the side of the boxes I had so I could check and listed the ingredients (I’m a list person) 😄
That’s interesting to hear your father confirms that the coating does make a difference - and he being a retired GP too).
I don’t think manufacturers or the NHS are too concerned because all they think about is the pennies they save. Obviously the Government are to blame for the NHS cuts.
That’s good you can get your preferred brand from a chemist - it is worth searching them out. I guess different parts of the UK source different brands.
Ojh3 CG55
Posted
coming off the hrt plunged me into severe anxiety.
i have now switched over from citalopram to venlafaxine. the citalopram , i think, has stopped working for me.. no better after 8 weeks at 30mg.
nicnicnicx3 Ojh3
Posted
hi, I have been on citilopram 20mg for 5 weeks and then upped to 25mg for 5 weeks and still feel very anxious. was it dificult to switch to venlafaxine and has that helped? I am worried about side effects and having to start again. I also think my symptoms caused by reducing levels of estrogen even though i was on HRT plus some health scares.
tina66425 katecogs
Edited
Hi,
about 5/6 years ago i was diagnosed with ocd-doctors put me on fluoxetine and after a few terrifying weeks I was doing much better and gradually got my life back. During that time I would look on this website for support (even though I wasnt even registered so was just a lurker haha) but your posts have been a massive help to me on my ocd journey, and 6 years later I am going through a spike/dosage increase so found myself back on here, I saw your name pop up on here and once again your posts are helping me through a scary time ,so basically just trying to say thank you, so much xx
katecogs tina66425
Edited
Hi Tina
Am so glad my posts have helped you!! Yes starting these meds or even increasing will enhance the anxiety a bit more until it settles again.
Aww thank you so much for your thanks ❤️
nicnicnicx3 katecogs
Posted
if it seems the SSRI is not working, would a different medication be quicker and more effective. Been on citilopram for 10 weeks and still struggling with awful anxiety and panic. I would say that there has been a very gradual improvement but can't go to work or function properly yet. Advice as to how much longer I should give
it
katecogs nicnicnicx3
Posted
10 weeks is too early to see any improvement, so you’re experiencing normal symptoms at the moment.
SSRI’s meds can take 6 months before you feel improvement - it can be sooner or it can be longer. Everybody improves at their own personal rate.
The SSRI is working - you just won’t see anything yet. There is no SSRI that will help you recover in an instant. Recovery from anxiety is lengthy, with or without meds. You cannot hurry recovery whatever you do, and trying to quicken it will do you no favours.
People sometimes don’t notice recovery at first because they expect the anxiety to lessen, but usually small things start happening first which go unnoticed ie better sleep, appetite improves and other things that they don’t associate with recovery.
Anxiety will stay with you all through recovery until the end.
You’ll also get setbacks when the symptoms all come back after you start feeling better. There will be many setbacks.
But for now you will still struggle with anxiety and all symptoms, it in time these will get easier.
Recovery time is different for everyone but it can be many many months.