When do I move on to the next stage to eliminate the panic?
December 10, 2013 11:12 AM Subscribe
I've been on 20mg of citalopram (Celexa) for about 10 days and I actually feel worse. At what point should I start CBT OR
at what point should I complain to my GP?
posted by anonymous to Health & Fitness (13 answers total) 2 users marked this as a favorite
I've always had a bit of a problem with anxiety and the occasional panic attack, but over the past few months it's been worse (3-4 panic attacks within about 4-6 weeks). I went to a new GP for the first time and he put me on 20mg of citalopram. Blood tests (for liver, glucose, thyroid, bone-something, and 2 other things came back normal).
I have read many places that if citalopram is to be prescribed for panic disorder, the usual thing to do is start at 10mg and work up to 20mg a week or so later, and further if need be. I have also read that when one starts taking citalopram for panic disorder, one is likely to experience more anxiety/panic/related symptoms in the initial settling in period before the beneficial effects start to be felt (I assume this is why it's normal to start at 10mg).
So...that is where I am now, feeling on the edge of a panic attack in situations where I used to only feel a little anxious. Occasionally stuttering when I would previously only stutter under extreme stress. Occasional tremor in the hand, totally new. And more, on top of staying in bed and napping away a lot of the day. Assuming I'll get over this in 1-3 weeks. Hoping it's sooner rather than later.
I have read that overcoming (or learning to live with) panic disorder (or high anxiety, or whatever) takes medication and therapy (usually CBT). Should I start ASAP? Or wait until my anxiety levels are brought back down to what they were when I started the citalopram?
And...given that it's predictable to feel worse before I feel better on the citalopram, at what point (3 weeks? 5?) should I return to my GP and possibly say 'hey, this doesn't seem to be working'? When should I stop just hanging on and actually ask the question if these are the right meds for me?
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