Help me deal with increased anxiety.
May 5, 2010 7:19 AM   Subscribe

I've read a lot about anxiety and other mental issues on AskMeFi, I went and talked to my doctor about it. He's prescribed Cipralex for me, and I started taking it last week. I'm having a hard time with a side effect though.

For this first week, I'm taking 5mg/day. Starting Thursday, I move to 10mg/day.
One of the side effects they noted was that I may experience increased anxiety at the beginning.
Well, I am. And it's awful. I'm sitting here questioning my entire life, and every decision, pretty much. I'm stuck at work and can't concentrate. If I go home, it'd just be worse, though.
I'm telling myself this is just a side effect, you knew this would happen, try not to think about it. But my mind is just racing like crazy.

Can anyone suggest any techniques to help me calm down a bit?
posted by anonymous to Health & Fitness (6 answers total)
You absolutely must call your doctor if you encounter a side effect that is making you uncomfortable. Your doctor works for you and s/he wants to hear if the medication is not agreeing with you. S/he is willing to help you and can make appropriate suggestions. (And if your doc isn't willing to help, that's a big red flag.) It's okay to "bug" your doctor--this is a person who works for you.

Call your doctor now. If you can't live with a side effect, the benefits of the medication are pretty much moot, no?
posted by corey flood at 7:27 AM on May 5, 2010 [1 favorite]

Take a walk. Increased blood flow in the brain (deep breathing or light exercise) can reduce anxiety. And it can break you out of the current negative feedback loop. Personally, I would take a walk to go get a chocolate milkshake or some other small indulgence, sit in the sun (Vitamin D is good for depression/anxiety) for 15 minutes, and try to reboot. For me, it wouldn't be a cure-all but it might help.
posted by bunnycup at 7:31 AM on May 5, 2010 [1 favorite]

Seconding corey flood, get in touch with your doctor now. It'll most likely get better soon, but it might be safer to get through this period with something to take the edge off the anxiety. And if you feel like hurting yourself, please, please go to an ER and tell them what's going on.
posted by greatgefilte at 9:12 AM on May 5, 2010

I have also been prescribed Lexapro (Cipralex) in the past - I am diagnosed with GAD and found it incredibly helpful, AFTER the initial anxiety phase you describe.

As others have said, call your doctor. My doctor put me on benzodiazepenes for the first month of the medication, specifically noting it was for the initial "getting used to" phase of the SSRI. Your doctor should understand this happens and would probably be willing to put you on something like Klonopin/Valium while you adjust to the effects of the medication.

An issue that may arise from this solution, however, is becoming dependant on the benzodiazepene. Let me tell you - there is absolutely no shame in being dependant on a medication if it truly helps you and your anxiety. I have dealt with a lot of personal guilt when it comes to these types of medications, feeling like I'm an addict for having to take something everyday if I wish to be a little less anxious. Don't get in this thought cycle! It has personally kept me away from the doctor for too long and I would hate to see it do the same to you.

I think a lot of people figure that a doctor may become suspicious of your motives if you let them know that the anxiety is still there, even worse than before, and you wish there was something else you could take. Part of my anxiety issue is thinking this - I have kept myself out of the doctor because I'm worried I'll be looked upon as some kind of drug seeker, but the bottomline is these medications help an awful lot for some people - it might take a month or two of treatment on a medication like Klonopin, but it also might take years or even forever. Never feel ashamed to take a medication that helps you lead a healthy, normal life.
posted by deacon_blues at 11:52 AM on May 5, 2010

Crap. I just got an rx for citalopram (lexapro pre-patent tweaking) because I finally admitted that the side effects of the previous stuff were not worth the benefit.

Don't do what I did, which was spend a year taking a not quite therapuetic dose because enough medication was too much side effect.

For the immediate moment, take a walk in the sun, do some other self soothing - music, a scent, an activity, and tell your doctor what is going on.

My doctor had no idea I was having these side effects. He didn't ask, and I hadn't volunteered the info.

I wish I had spoken up sooner, but I'm glad I did today. (seriously, a few hours ago!)

Feel free to me-mail me, or real email me, if you want to talk to a fellow snowflake :)
posted by bilabial at 12:27 PM on May 5, 2010

I had the same side effects when starting Lexapro/Cipralex. I began with 5 mg., and my then-therapist said. "You likely won't feel ANYTHING at that small dose." Well, each day I felt as though I were amped out of my mind on caffeine, and then, after a few hours, uncontrollably sleepy, as in, falling asleep at my desk sleepy. It was like a rollercoaster ride, only self-induced. I had to increase my dosage very slowly, first to 7.5 mg. (lots of pill-dicing with a pill cutter), and then finally to 10 mg. I was taking a benzo (Ativan) concurrently for a while, as well.

Meditation helped me on some of the tougher days--I used the body scan meditation in Jon Kabat-Zinn's Full Catastrophe Living.

The good news: I stuck it out, and after a few months had no side effects at all, except for relief from lifelong anxiety.

My current therapist says he'd have started me on Prozac (fluoxetine) instead, as it has a "smoother" action, according to him.

Good luck, and feel free to memail me if you like.
posted by sister nunchaku of love and mercy at 4:12 PM on May 5, 2010

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