Early Morning Anxiety

I have recently fallen into a bout of anxiety -- this is my 2nd major bout -- the 1st occured 5 years ago.  Everything seems to be progressing nicely this time around -- as compared to last time -- except for one major issue.  Every morning (like clockwork) I wake up with a trembling/shaking of my body.  This always happens one to two hours before my alarm clock is supposed to go off.  I have no problem falling asleep at all.  But every morning I awake to these tremblings/shakings -- that mimic a panic attack -- because I also experience rapid heartbeat and sweaty palms/feet.  I have to do deep breathing and muscle relaxtion to get myself right -- and even then I'm shaking during the day.  What do you think this is?  I'm taking 40mg Celexa and no benzos.  I used to take the Celexa in the morning, but take it at night now -- thinking the change would change my early morning shakings.  This has not changed anything.  I know tremors is a side effect of Celexa -- but I'm been on Celexa for 2 months now.  All of the other side effects have gone away.  But I still have these tremors/shakings/tremblings.  Do you think 40mg is too much and I should cut back to 20mg?  Your thoughts please as this is VERY frustrating -- as it happens every singe morning.  Thanks!

[Roger Gould, M.D.]

The shaking may be an anxiety break through, which would suggest you increase the dose; or a side effect of the medication. The best way to find out is to experiment by reducing the dose and see what happens, but this should be done under medical supervision.