Thoughts anyone?

Brilliant, that's great.

I will stay on 225mg for now and might scale down the same as you after I feel the levels have stabilised.

Thanks for your reply it's appreciated.

Just to make sure there is no misunderstanding: I did not scale back once i was better. I was scaled back when it became clear that the experimental increase in dosage was creating some unusual symptoms, which led the psychiatrist to believe I will be better off back on 150mg. Which was true and i progressed well.

Once a dose is found that brings steady improvements, and a higher dose is attempted just to confirm, the final optimal dosage must not be reduced until you are entirely symptom-free for a while. My psychiatrist always insisted on 2 years maintenance with me and other patients of his that i have met over the years. Other doctors allow 6 months symptom free but i noticed higher relapse rates during my research.

So to be clear, I scaled back from final optimal dose of 150 after 2 years treatment+2 year stabilizing+2 years maintenance (during which time I was absolutely symptom-free) at 150mg. The tapering took 2 years. Total time-frame 8 years start to finish. This was 4 years ago and i have been drug-free and thriving since. I am sharing those details for you to hear from someone who successfully completed therapy they were told they will have to take their whole life by another doctor...

Different people will need different time frames, but i am pretty sure no scaling back off the optimal dose is advised without first completing at least 2 years therapy and that minimum therapy time with minimum relapse risk is 4 years total from start to finish. Just FYI.

 

Thanks, I understand what you mean. I was good at 150mg by week 7 but I felt that in certain trigger situations my innner critic was still there and very irrational. I worked with it via CBT and mindfulness for a few weeks more but it almost felt like that the tablets had nothing more to offer and there was no changes up or down, so I increased to 225mg. I had a lot more energy by week 7 on the 150mg and my humour was back more by this time. I'm at week 8 now on the 225mg and they are still levelling out as everyday I feel different. I didn't expect it to take so long, I thought it would be the same times scale as the 150mg. I feel a lot more relaxed at present but still having head pressure and the odd headache and like my brain is going 250mph or buzzing so to speak. But I had this before on the 150mg right before they kicked in.

My plan is to find the level that works best for me as you say, i suppose I wasn't sure if I increased too early as I have recently read it can take longer for the symptoms of anxiety to fully disappear whereas depression lifts an it quicker. (Not sure if that's true) when you say you had unusual symptoms what are you referring too if you don't mind me asking

I hope the question is directed at "unusual symptoms" when the dosage was notched up to 187.5 experimentally? Because my initially presenting symptoms will require a separate site to list LOL.

By unusual I meant different to my original symptoms not unusual as in far out.

Once the doctor tested me on 187.5, from 2nd or 3rd day i had a strange sensation of head pressure and an odd discomort at the top of my head. My body felt like i had taken an energy drink too many causing my spine to stiffen up (i have actually overdosed on shark some years earlier and this is exactly how this felt) but unable to let out steam. Some slurring of speech but very discreet. Psychologically i was ok, no better or worse than on 150mg. It was physical responses that were off. Except the annoying constant sensation of head pressure i thought nothing much of it the first week. But after the 2nd week i realized something is a bit off. I waited for my next appointment the following week and when asked told the doctor i was the same as before but with the above additional sensations. By this time i had a constant headache as well but was in great spirits So the doctor said: well yes you look overdrugged. The symptoms you have show you are clearly overloaded." At the time i did not expect him to say that - i thought he will continue to up the dose in fact because of those symptoms  . He said to stop the additional 37.5 starting the same day and continue back on 150. The added symptoms disappeared over about 3-5 days and I was just fine after that.

What kind of a doctor is monitoring you? GP or psychiatrist?

No 7-8 weeks is a good time to experiment with higher doses. However your optimum may be a bit lower than 225 or a bit higher. I am not keen on 75mg increments going up or going down. I remember those were quite unpleasent in the first lap of my therapy before I found my final psychiatrist. 37.5 nice and steady does it.

You should level out (adjust) at 225 sooner than from 75 to 150 actually. So i would definitely bring this up with your doctor.

Other than this, anxiety ups and downs are expected throughout the first year or two of therapy on your optimal dose. I know what you mean by feeling different every day. Your brain is reeling from all these changes as well as overall exhaustion from the condition itself. Be kind to yourself and try to laugh some of it away too

As for anxiety persisting longer than depression - according to doctors as long as you have anxiety you are harbouring depression/repression. For me feeling  low diminished notably as soon as my anxiety started improving. I was most disturbed by anxiety and not by depressive signs. So once i felt more 'with it' my mood and energy also improved. This is very subjective i think.

What a fun condition! x

Yes I meant due to the experimental increase lol.

I'm seeing the GP or they are seeing me so to speak. They will pretty much do what I ask of them. I originally saw a psychiatrist to get diagnosed and get the correct type of tablets privately, but I've not gone back due to larger costs.

My symptoms arent any different to when I was on the 150mg, it's just that they are still here at 8 weeks and the 150mg it was all ok by week 7. Which is now causing some slight anxiety hence why I'm on here.

I'm just going to wait until they level out and that there is no changes for a while before i review again. At the moment my motivation is very up and down and I have a lot of head pressure changes. Almost feels like if my brain was a battery then someone has turned the voltage up to maximum and it just needs to calm down. It was like this before though.

Also when I increased to 225mg up went through all the old side effects but just not as severe.

225 could be a bit high for you but honestly i would only trust a psychiatrist with the fine-tuning now required. Typically 4 weeks is more than enough to evaluate the level so I would have a word with the doctor and see what he says. If he suggests further upping dose, I would invest in a one-off consult with a psychiatrist on the subject of optimal dose adjustment/second opinion. Just to avoid messing up.

 

Thanks, I don't think I'm going to increase just yet, I'm going to give it some more time but if I feel I have too then yes I will see a psychiatrist.