Waves of anxiety

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I've been on Zoloft and now on fluoxetine for a total of about 12 years. I still feel like I have days, especially during the evening where I feel jittery, anxious and crappy. I feel sad even though I have nothing to be sad about! I know I should be on meds and I'm too scared to try a new one. Is it normal to have bouts of anxiety here and there even after I've been on meds for so long?? Looking forward to your insight......

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  • Posted

    Hi Sandy, it is possible that you are experiencing tolerance withdrawal, where the same dose of medication causes withdrawal symptoms, anxiety and depression among them. You are a long time user so it is very possible this is the case.  It is the very fact that you have been on so long that tolerance is very much a possiblity!

    Would you say that you are feeling worse now than previous years on this drug?

    I believe you are experiencing what is known as "neuro emotions."  Feeling sad with no reason for it would be a neuro emotion if you are in tolerance.  Neuro emotions are versions of depression anxiety, anger, irritability etc. that are beyond what is reasonable for you.  They may have a seed of truth to them but are extreme for you.  Or, they may be entirely chemical with no trigger, as you said you feel sad without having a reason.

    Studies have shown that chronic antidepressant use causes people to become MORE prone to depression, paradoxically.  Maybe it is the tolerance withdrawal causing it, not sure whether a reason has been proposed.  This was the case for me after 12 years of Effexor use and others for 8 years prior.

    I do think you need to discuss this with your doctor.  One response by him might be to increase your dosage, but I really don't think that is a wise course because you will soon find yourself in the same boat but on a higher dose, which means a much farther journey should you need to change meds or come off.  When at a high dose for years, you CANNOT simply do a taper off over a month or two, as most doctors will have you do.  Your brain remodelled to take the action of the drug into account and then became very dependant on that drug's action for "normal" functioning.  To come off so quickly as most doctors have us do amounts to a cold turkey.  Think of your brain as a vine growing on a trellis (the drug); if you rip out the trellis, the vine will collapse.  That is withdrawal from sudden cessation.  A very slow taper is more appropriate, making small changes such that the brain can adapt without much durress.

    Even if your doctor switches you to another drug, the new drug won't necessarily negate withdrawal from the one you are on, so a direct switch is not adviseable.  You must taper off of this med slowly, no matter what your next course of action is.

    I strongly encourage you to join a support forum called Surviving Antiedpressants, where you can create an intro and put forth your dilemma.   They are very knowledgeable there and also very supportive.  Yes, it is a forum for those wishing to get off their psych drugs sanely, but I think the folks there could give you excellent information and guidance, even if your ultimate goal is to switch to another med. 

    I think you should do your best to get informed before seeing your doctor.  Ultimately, this is your brain and your life, and harm reduction is the ultimate goal for you.  Sometimes we have to really advoated for ourselves and be prepared to say "but wait..." if the doctor proposes something that you have learned might be too precipitous.  

  • Posted

    I'm kinda wondering the same.... I upped my dose and now I feel sad and low and anxious some days.... I was on 20 mg for 2 years and 40 mg 10 weeks..... The 20 was doing great for me but 13 weeks ago I had my son and started getting depressed so they upped it. Now I feel miserable.... I f don't know if it's the med s or the hormones!
    • Posted

      One thing I have learned about being in withdrawal is that I can be doing well and then a big stress will throw me into withdrawal.  Having a baby would certainly qualify as a stressor that could bring up symptoms.  You might go back to the previous dose and wait to stabilize.  It might take some time since you have bounced around a bit, but that is something to consider.

      I've read that when in tolerance, upping the dose can be paradoxical because you have become sensitized to the drug.

  • Posted

    Sometimes SSRI's don't work for a few people, and it may be that you need an SNRI instead.  Both these meds work on different neurotransmitters, and it may be that an SNRI would work better for you.

    After 12 years you shouldn't be getting anxiety regularly.  Of course our bodies still need to react to stresses of life and so a little anxiousness is normal, but not if you still feel it's affecting your life.

    Other than it being just a chemical imbalance, is there an outside cause that's keeping the anxiety there?  CBT would help in that case.

    Have a chat with your doctor.

    K x


    • Posted

      Thanks for the info. I didn't know about the two different types and will definitely talk to my doctor about it

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