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Mental Health (Expert Forum)
Celexa for depression and anxiety?
Answered by
Roger Gould, M.D. - Mental Health, Wellness
Questions posted in the Mental Health forum are being answered by Dr. Roger L. Gould, author of the Mastering Stress and Depression program and affiliated with the UCLA. Department of Psychiatry. Topics covered include anger, attention deficit disorder (ADD), bipolar disorder, dementia, electroconvulsive therapy (ECT), learning disabilities, memory, obsessive compulsive disorder (OCD), panic, personality disorders, phobias, post-traumatic stress disorder (PTSD), schizophrenia, stress, transitions, and work problems.
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Celexa for depression and anxiety?
by gwenk, Aug 18, 2005 12:00AM
Hi Dr.,
My MD switched me from Paxil 40mg to Celexa 30mg a few months ago. I ramped up gradually to the 30mg. I still have horrible anxiety & depression, though. It is much worse in the mornings than afternoons. I wake up at about 3AM every morning & can't go back to sleep. I've been this way for 2 months & can barely function anymore. Dr. always says just try upping the dose. I tried to up to 40mg for a week, but felt even MORE anxious. Is there a different med which is more effective for depression & anxiety? In the past, I've tried Wellbutrin & Zoloft which both had me climbing the walls. Paxil definitely worked for a long time, but stopped working. I also take thyroxin & cytomel because I don't have a thyroid anymore.
Please help! I've gotten into this bad spiral & can't seem to pull myself out of it. The not sleeping is definitely not helping the problem .
My MD switched me from Paxil 40mg to Celexa 30mg a few months ago. I ramped up gradually to the 30mg. I still have horrible anxiety & depression, though. It is much worse in the mornings than afternoons. I wake up at about 3AM every morning & can't go back to sleep. I've been this way for 2 months & can barely function anymore. Dr. always says just try upping the dose. I tried to up to 40mg for a week, but felt even MORE anxious. Is there a different med which is more effective for depression & anxiety? In the past, I've tried Wellbutrin & Zoloft which both had me climbing the walls. Paxil definitely worked for a long time, but stopped working. I also take thyroxin & cytomel because I don't have a thyroid anymore.
Please help! I've gotten into this bad spiral & can't seem to pull myself out of it. The not sleeping is definitely not helping the problem .
Doctor's Answer
by Roger Gould, M.D., Aug 23, 2005 12:00AM
, Aug 23, 2005 12:00AM
There are other medications like Lexapro, Buspar, Klonopin, Prozac. YOu can ask your doctor about any of these for trials, but which ones will work depend on how much of this is anxiety and how much depression. If mostly anxiety, you might stop the antidepressants and use klonopin which will also help you sleep, and that in itself may help your depression. Also, have you tried psychotherapy, which is really the best of all medicines. You might also get going on solving some problems at masteringstress.com
I'm sorry that you are not feeling well. Not sleeping is probably adding to your situation. I've never met an antidepressant that did not wire me. Paxil, Wellbutrin, Zoloft all left me feeling edgy and made my insomnia worse! Caffeine with these antidepressants can really make you feel edgy. For some people, these drugs are sedating, but for others...like you and me...they seem to have the opposite effect.
Please talk to your doctor about all this. It seems that you may be sensitive to the medications. Maybe he can give you something to sleep and you can see if that is helpful to you. Lack of sleep can make you depressed and anxious, too. I've been off everything for a year. I exercise 4 times a week and it is extremely helpful for dealing with depression and anxiety.
Feel better soon!
make sure the thyroid meds aren't adding to the problem as well. I am on Zoloft and the earlier i take it the better i sleep.It stimulates the sleep center in the brain and theres no way i can get a wink of sleep if i take it later than 2:00 in the afternoon. The morning is the best time to take it. My best friend is on the Wellbutrin and a small amount of the Zoloft and she is feeling ok except for headaches. She eventually wants to get completely off the Zoloft and just do the Wellbutrin. If you take alot of meds together the harder it is to figure out what is right and what is messing you up.
-vertigo(wow, it has a name? I thought I was crazy for feeling this!)
-flu like symptoms
-extreme moodiness
-tremors
-etc, etc, etc...
Anyway, my doctor said nothing about weening off of Paxil. Are the effects of Celexa supposed to (for lack of a better phrase) take over where the Paxil left off? The withdrawl is not so extreme as to concern me much. Actually I feel better already. I'm not as tired and I actually have a sex drive now, hallelujiah! Then again, its only been a week, so here's hoping the withdrawl doesn't get any worse. Does anyone know how long paxil withdrawl lasts???
Have you been eval'd by a psych or is your PCP RXing these medications?
Has he screened you for bipolar or add? have you ever tried a hypnotic medication (like ambien?)
Some of the symptoms you are presenting with appear somewhat hypomanic (if not manic). There is currently a warning on all SSRI's for physicians to screen for bipolar disorder because of the risk of manic switch.
If negative - I've had quite a bit of success with patients in your circumstance by adding Seroquel-100mg at night with Lexapro and BuSpar during the day. It helps with sleep and seems to calm anxiety during the day with a lot of my patients.
I would definately suggest some exercise too ... this can really never hurt.
I exercise 4 times a week for 45 min-hr each time. My PCP is the one who is prescribing the meds, but I have also been evaluated by a psychiatrist this week. I don't think that they've evaluated me for bypolar or ADD, but I'm pretty sure I don't have those things. I get the lows, but not the highs. I can't concentrate right now because I'm not sleeping, but usually concentrate just fine. Talked to my PCP again yesterday & he suggested trying to up the dose of Celexa to 40 mg & giving it a few weeks to kick in & for my body to get adjusted to it. In the meantime, he prescribed some Xanax to help me relax when I wake up early in the AM. The psych said the same thing.
I did try ambien for a few nights last week, but it didn't help keep me asleep. I have no trouble getting to sleep at night..its staying asleep that's the problem.
Any good meds for STAYING asleep throughout the night??
This is just killing me...
In similar cases, I've prescribed Seroquel - 100mg at night to aid in sleep. If you don't want to go that route -- recently, the Sepracor people have been in my office quite often and say that Lunesta has quite a long half-life (roughly 8hours). Given this, it should help you to stay asleep - although I have not used that much of it yet (it's very new). Ambien is great for people who can't get to sleep initially.
Let me know your progress.
best,
ckg, MD
Good Luck!
I have been on Zoloft for about 4 months now. It seemed to help a lot with the depression the first month or two, but now I don't feel like it's helping at all. My anxiety is regularly increasing and I've been sleepy all the time. I have to switch doctors due to insurance and I'm hoping the Internest can lead me in the right direction or refer me to someone. I'm feeling a little helpless these days, but I don't want to just stop taking Zoloft without talking to a doctor. I also don't want to go back to the way I use to be with the panic and anxiety.
Isn't there anything that can help with anxiety and depression?? Oh yeah, I gained 20 lbs. in the last year, which really isn't helping the depression either!