All SSRIs are appropriate to be used as an anxiety treatment, despite being classed as an anti depressant. Instead of YOU deciding which med you want, you're better off explaining to your doc what has been going on, and see what he recommends.
While two meds might both be SSRIs, they all work a little differently in their mechanism of action. The end result is the same (an increased amount of serotonin in the brain)..but how you get there is different with each med, hence why there are so many varying experiences.
Cymbalta tends to be a bit activating, so that may not be the best choice, ask your doctor about it. There's no way to predict how you will do on something else, but let's hope well. I STRONGLY urge you to have a back up plan in place to help deal with any side effects, should they occur. A short acting benzo would be appropriate. I know you're fearful after your experience with Xanax but it's worth a try. Ativan tends to be a little less intense, so you could try that. Again, mention it to your doctor. Whatever you do...don't make any changes...stay on your current dose of the Zoloft until you get in to see him.
Again, remain open mided. Do NOT go into the doctor's office with a mind full of what you will or won't take. Let the doctor make some recommendations, then have a discussion from there. With the new world of google, we are all so quick to want to play doctor...lol.
Good luck....update us on the new plan.
.... or have thought about Cymbalta??? Those are the other two my doctor has mentioned. Trying to decide which would be the next best step after Zoloft.
I keep commenting on my own post. lol. I want and NEED an SSRI that is approved for anxiety.
Advice12 - I have such a difficult time with most medications, especially SSRI's, but I can't even take a Sudafed without being jittery and feeling strange. Granted, we are all different, but with that being said, I had virtually no side effects from Lexapro. Celexa is very close in chemical makeup, but that one didn't work well for me for my anxiety. I know it does for others, with minimal side effects, so it may be a good choice.
Lexapro is very similar to Celexa, it has one of the main components of Celexa, and tends to be overall easier to tolerate, so yes, if you ARE going to discuss that with your doc...that may be the way to go.
Good point, kickbutt! :0)
nursegirl, ahhhh! I knew I could count on you for advice! Thank you. I hate google. lol. I play doctor all of the time. I googled last night and read that Paxil is one that doesn't (usually) accelerate tremors but I read weight gain is ridiculous on it. I also read the Prozac is good too but I think Prozac is activating. I need sedating. I am glad you said that about Cymbalta. I need one that will not make my tremors worse.
kickbutt, My doctor wanted to orginally prescribe Lexapro but coming to find out my insurance doesn't cover it. I don't understand why because I have decent insurance. I hope if I do try Celexa that it works well for my anxiety but mainly I need a med that will not make my tremors bad.
Thank you both for your help. I found the Zoloft to work at lowering my anxiety and depression but it made my tremor bad. I feel hopeless. I hope they all don't do that.
That's the drawback of Lexapro...my insurance didn't cover it either. When I had Blue Cross insurance, I was able to get a prior authorization from my doctor because I'd tried so many other drugs with no avail, so the insurance company gave in and made it a covered drug. However, last year when I switched jobs and insurance companies, there was no way around it. The generic just came out this year, but even with insurance the co-pay was still $100. I hope that the Celexa works for you, though. The people I know who have taken it haven't had any side effects from it. Let us know!
That's the thing about google...so much info, and it's hard to sort it out and determine which are reputable sources. Also, reports of experiences with meds are all over the place from person to person. Some report weight gain with one med, others report loss, others report no change. Same with any other side effects. That's why it's best to keep your info seeking to basic information. You can drive yourself crazy! See what your doctor recommends. He may have an idea non of us have thought of.
"Again, remain open mided. Do NOT go into the doctor's office with a mind full of what you will or won't take. Let the doctor make some recommendations, then have a discussion from there. With the new world of google, we are all so quick to want to play doctor..."
Good advice. If you suffer from anxiety relating to your medication, also, it'll be hard to respond naturally to your treatment if you've done far too much reading up and worrying about side effects, etc.
If it's anything like in the UK your Dr may well have a straight second line treatment to go to which is affordable and recommended for anyone not responding to your current therapy. It may be different due to the huge difference in nature between our healthcare systems, however.
Thank you. How is everyone? I am not able to make my appointment on Thursday. =( I was looking forward to asking him about the next medicine. The lady in the office said she will call me if they get a cancellation for Friday. In the meantime I am going without medicine. I can't wait to get on something again, that does NOT cause tremors.
Oh hun, you really should have just stayed on the Zoloft until you could get in to see him. How long has it been since you took the Zoloft? How are you feeling?
It's been several nights now without it. Maybe 4 nights. :( My tremors have improved. I have been emotional today & have felt a little more anxious. The Zoloft was helping me a lot with depression & I could see a difference with my anxiety but I can't physically handle the tremors. They weren't mild, they were severe. I hope I am able to get in soon & get on something that doesn't cause me to shake like that. Thank you for your help through this.
nursegirl, advice needs your advice! =) I was able to get into my doctor today. He said his next pick would be Lexapro or Viibryd. I chose Lexapro since Viibryd is a new drug and I was unsure about it. My concern is insurance doesn't cover Lexapro. I hope they are able to make it go through. He also gave me a script for Valium. I was shocked he didn't give Ativan or Klonopin or something along those lines. Is Valium good? He said if insurance doesn't cover the Lexapro then I could try Vivbryd, a new med, but I don't like that idea. He said I could try Paxil or Prozac but Paxil is known to cause a lot of weight gain and they both can have interactions with other drugs and not so good on the liver. What do you think? If I can't get Lexapro covered what would your adice be? He is letting me decide.
Lexapro came out with a generic a few months ago; however, I have Health Partners insurance and even with insurance, the co-pay is still $100. If you have a different provider, I would ask your doctor to submit a prior authorization for the drug, stating you've tried other drugs with no success. I had to do this for seven years with Blue Cross Blue Shield, but Lexapro was the only drug that worked for me, and then they did cover it.
$100 is high! Did you take the generic? IDK why but I want to take the name brand.
Maybe I should have asked for Celexa, he also mentioned it. There are way too many to choose from.
I think Lexapro is a good med to try next, hopefully your insurance will cover it. The generic was recently approved, so it may not be available everywhere. One option would be, if your insurance denies it, you could speak with a few Pharmacists in your area, nd ask them to try to obtain the generic for you. That may be an option.
If you can't get the Lexapro either way, I think trying the Viibryd is the next best option. I know it's fairly new, but so far, I've heard a lot of reviews thus far. No different than trying any other new med. Let us know, hon!
Good news! I called the pharamacy to check on my prescriptions. My insurance is going to cover it! I am not sure why. I thought for sure it would be a long drawn out process to get them to cover it. I asked about name brand and they said they will switch it out for me & all I will have to pay is a co pay. I am one happy girl right now! I hope this works. I will keep you posted. Thank you for being here for me through this. I hope to report back one day with my anxiety & depression under control, on a medicine without nasty side effects. I guess if this fails then I will give Viibryd a chance but I hope this works. I plan to take the Valium as needed. Do you think Valium is good for anxiety and will help with start up side effects? I hope this works.
Great news! I will keep my fingers crossed that the Lexapro does the trick! The Valium will definitely be helpful? How was it prescibed,
"as needed"? What is the mg dose?
I am not sure but when I get them later I will let you know. Let's hope this does the trick! I hope it doesn't cause shakes like Zoloft did.
Lexapro is 10 mg and Valium is 2mg (once a day). Does this sound like a good start?
I was tempted to go with Paxil despite everything my doctor said. I hope I made the right choice with Lex.
I think you made a good choice. Lexapro is literally the only SSRI I've taken that has not caused severe side effects. I have a very difficult time with drugs and this one was a godsend for me. (I've tried Celexa, Zoloft, Paxil, & Effexor.) I took the generic for a month and didn't notice any difference in it's effectiveness versus Lexapro.
That makes me feel better. Thank you. When he said that Paxil was sedating but then mentioned the side effects (possible drug interactions, not so good on the liver & excessive weight gain) I chose the Lex. Did you have any start up side effects? I plan to start it tomorrow night. =) How have you been?
I had zero side effects from Lexapro and it worked really well for me for eight years. It's the only SSRI that didn't cause me any bad side effects; Celexa wasn't too bad either, but it didn't work well for me. I'm the same...barely get out of bed, anxious all the time. I've been on the Zoloft for over a month now and don't see any improvement, but my doctor wants me to give it another two weeks...oh...and now I have hand tremors. :)
Not hand tremors! That is the one and only reason I had to stop taking it. I hope I don't get the same effect from the Lex. What mg of Lex did you take? I hoped by now you will see some improvement. If you don't in 2 weeks what will the next course of treatment be? Are you not getting out of bed due to anxiety or that you don't feel well?
Yep, tremors! I have been on my laptop a lot lately so I noticed it a few days ago, but it may have been going on this whole time for all I know. They aren't interfering with my daily life, though, so that's at least good. I was supposed to start off on 10 mg of Lexapro, but the pharmacy screwed up the order and gave me 20 mg. My doctor looked in his Journal of Medicine and showed me that it's been proven there is virtually no difference between 10 and 20 mg, so he kept me on the 20 mg dosage. I had ZERO side effects with Lexapro, and I can't say that about any other SSRI, and even a lot of other drugs. I can't even take Sudafed without getting jittery, and have a hard time with some antibiotics, so I hope that Lexapro works as well for you as it did for me.
I haven't been out of bed much this week, with exception of today. I e-mailed my doc and told her I'm so depressed that I don't even feel like getting up anymore (regardless of how I feel), that I feel worse on the Zoloft than off, that I quit my job because of this, etc. Her response was to try Zoloft for two more weeks, what I'm experiencing is "normal", and that "once the dust settles, quitting my job may be the best thing for me". She kind of missed the point that while yes, my job was awful, anxiety shouldn't be so bad that it forces you to quit your job because you can't physically handle it. Ay yi yi.
I have a therapy appointment tomorrow, so hoping the psychologist has some ideas for me, but I've about given up on therapy. One I saw for two months kicked me out, as she couldn't find any rhyme or reason for my anxiety, and said I'm very rational and didn't need to be there. :p I tell ya', I sure don't feel like the most normal person!
Have you started on the Lexapro yet? I think part of the reason I didn't have side effects from that drug is because I tried Paxil and Effexor for about six weeks prior and those gave me some nasty effects. I think my body probably built up a bit of a tolerance already, and the doctor concurred, so hopefully since you already took Zoloft for a month, you will have an easy time, too!
Keep us posted!
Are you feeling better? I haven't been on in a while. I haven't felt the best. I started the Lex this morning. I am nauesous and guess what???? I feel a little jittery. Shoot! I had such high hopes for this. I will give it some more time since I just started. I don't understand. Maybe my body is rejecting SSRIs. I don't know. I hope the Z has kicked in for you.
Do NOT get yourself stuck in the trap of assuming that every little sensation means you mean not tolerate a medication. MANY of these meds will cause some degree of side effects for a lot of people....and EVERY thing you have described are common side effects. Also remember what I told you about going on these meds the second time around and that it may me a bit more difficult? That, coupled with your history (or tremors for example)...you HAVE to be patient and HAVE to expect that you may (MAY) have a few rough weeks. The trade off is well worth it though.
You have taken one dose of the Lexapro and already have instantly started negative thinking, worrying if you are going to be able to tolerate it. WAY too early to make ANY kind of determination. To be fair, you have to give this at least about 4 weeks, to give any side effect a change to start improving, and to let the med start working.
Your experience with Zoloft was unfortunate, I still think you would have come out on the other side feeling better, and the side effects would have ceased, but I understand you couldn't stand it anymore and I don't blame you. I DO think a big part of it was you sort of setting yourself up to fail a wee bit, and I would hate to see you do the same with the Lexapro.
It will be NORMAL in the next 1-2 weeks (maybe a bit more for you) to feel more anxious, jittery, have some possible GI upset (nausea, diarrhea), insomnia, drowsiness, headaches. Those are commonly reported, initial side effects. The Valium will help with some of that.
Try VERY hard to have a positive attitude about this....tell yourself this WILL work, and it will be worth enduring a short period of time with side effects IF you get them.
THIS post of yours is classic negative, self defeatist attitude:
I started the Lex this morning. I am nauesous and guess what???? I feel a little jittery. Shoot! I had such high hopes for this. I will give it some more time since I just started. I don't understand. Maybe my body is rejecting SSRIs. I don't know. I hope the Z has kicked in for you. .
ONE dose, and you're talking about your body rejecting the med? Saying you "HAD" such high hopes? ONE dose, darlin'! ONE! That's nothing. Give yourself some time with this...the busier you stay, the better. If you don't distract yourself, you will continue to overthink this, catastrophize every sensation, and simply set yourself up to fail. Give this a chance. You can do it!
Thank you. I am not giving up on the Lex. What I am feeling (I KNOW) is start up side effects. I will give it some time. I do believe I gave Zoloft a fair try. I was on it for 4 weeks. It's easy to tell someont to stick it out when you are not the one experiencing the side effects. When your entire body is jerking & you can barely hold a fork to eat then it's hard to stick it out but I did for 4 weeks. The excessive tremors subsided once I stopped the Z. I appreciate all of your help through this... going on these meds is not easy. I know several people on SSRIs. One person could not tolerate Lex but can Paxil while another person could not tolerate Zoloft but can Lex and another person loves Zoloft. We all are different. I have to find the one that works for me. I will give this 4 weeks, as my doctor suggested to see if this is the one for me. I hope it is but I am not going to give up after only a day on it! I stayed on the Z for 4 weeks having terrible side effects. I don't quit easily. =) I know your are showing tough love. I appreciate it.
I have never experience side effects from a drug the first day...it has always taken at least three days before I noticed any of them, so I'm wondering if you may actually be experiencing withdrawal effects from the Zoloft. Since you were on the Zoloft for four weeks, it's likely you will experience some withdrawal effects. When I switched from Lexapro to Zoloft I was extremely nauseous and had a terrible headache, but after about three and a half weeks, those side effects went away.
I am happy to report that while I am nowhere near "normal", I feel AMAZING! I pretty much changed overnight, but I don't believe it's entirely just the drug working, I think it's mind over matter. I had an appointment with my therapist on Wednesday and told her how I was barely getting out of bed, how I'm dizzy all the time, how I feel like I have no reason to even get up in the morning because I'm so depressed. She told me I need to take a walk each morning, relax three times daily for 30 minutes, and at least talk to people daily (some days I wouldn't even answer my phone). I just told myself I HAVE to start making changes, so after therapy on Wednesday, I went to the store and then had a friend over. Thursday was a bit of a setback, as I was really dizzy, but Friday and yesterday were awesome....I went to stores for more than an hour each, and last night drove out of town to a friend's house! That hasn't happened in a long time! The psychiatrist also told me to take Xanax in the morning and at night while I up my Zoloft dosage (upped it again yesterday). Maybe this is something you'd want to consider.
With all that being said, I know you can feel better, too! It's so easy to lose hope...I felt at rock bottom on Tuesday, and on Wednesday, I felt like God gave me a miracle. The thing I just learned this week is that general practicioners really don't know a lot about what works best as far as SSRI's are concerned. I found out that 20 mg of Lexapro (what I used to take) is equivalent to 150-200 mg of Zoloft, yet I was only taking 50 mg. Additionally, in the past I had to switch to Celexa due to insurance coverage and my doctor put me on 20 mg of that...well...guess what? The dosages aren't interchangeable, even though the drugs are very similar. The psychiatrist told me that 20 mg of Lexapro is equal to 60 mg of Celexa, so of course that didn't work for me. So, my point is, if one drug doesn't work, don't be afraid to try another, but try to stick it out as long as you can. And sometimes your dosage just needs to be adjusted, or another drug added (like Abilify, Buspar) to assist.
I really hope you feel better soon! Hang in there!
Excellent post! You made a great point, that while the meds may do a lot to help, attitude helps a lot too. It IS a lot about "mind over matter". I know, for ME...I started making huge strides when I started getting mad and fed up. I thought, "The HELL with this" and made a promise to myself that I'd do whatever it took. The harder I worked at it, and the more I THREW myself back into normal life (as uncomfy as I was sometimes), the better I felt, Distraction is HUGE with anxiety and depression. The more we sit around and worry and ruminate, the worse we feel. None of it is easy, that's for sure.
I am happy to see you are doing better. I hope to join you soon! =) I experienced some side effects on Zoloft, mainly the tremor, but I felt a huge relief from depression & somewhat with my anxiety. I couldn't take the tremor. It was having an impact on my life, especially when trying to eat dinner. I know it wasn't just in my mind as it is stated under side effects "tremors". I plan to give the Lex 4 weeks. Congrats on getting back to your old/new self.
I understand completely. I think if they hadn't subsided any by four weeks, they probably wouldn't have. I am having hand tremors on the Zoloft, but they aren't enough to hinder anything I need to do. I really hope the Lexapro works for you; I loved it, and my doctor told me it's in a different class than the SSRI's that you generally build a tolerance to, so hopefully you can take it successfully as long as I did. Do you think a pill for nausea may help you while your body adjusts? Pepto or Zantac?
Good idea about the Pepto or Zantac! I am feeling jittery but it's not near as bad as it was on Z. I already feel hopeful since it's not as bad as with the Z. I can't wait until this fully kicks in and see if it will help. =)
It's been a while since I've seen you on here. How are you feeling? Any better?
I think I am 10 days into the Lex. So far MY experience is the Lex has less side effects than the Z but I think the Z worked better. Not unless it takes longer for the Lex to kick in. I know after a week on Z I already could feel a difference. I still have an enhanced tremor with the Lex but it's not has bad as it was on Z. How are you?
What dosage of the Lexapro are you on? The thing that I just recently learned is that MD's don't know anywhere near as much as psychiatrists do about SSRI's. I was on 20 mg of Lexapro and my MD put me on 50 mg of Zoloft. I saw a psychiatrist, though, and she said that I was on much too low of a dose of Zoloft to be equivalent to Lexapro. If I remember correctly, you were also on 50 mg of Zoloft, correct? It took me about six to eight weeks on the Lexapro to feel better, but once I did, it was FANTASTIC!
I'm not having a lot of luck with Zoloft, at least not yet, though my dosage was too low for several weeks. I've been on 100 mg now for only a week and a half, though, and the psychiatrist said I'd need to be on 100-150 mg to be equivalent to what I was taking on Lexapro. So, I'm hoping that after being on the 100 mg for a few more weeks that I'll start feeling better. I had a GREAT nine days a couple of weeks ago; I finally felt like I was getting my life back, but now I feel worse again. Two steps forward, three steps back, I guess.
Do you feel any better than last week?
10 mg of Lexapro. I was on 25 mg of Zoloft.
I am not seeing any improvement on the Lex. I've had a headache off & on for days. My Google search shows that this can be a side effect. I don't know if I will stay on the Lex if the headaches don't subside. It goes to show that we all are different. I found the Zoloft to help much more than the Lex. If it wouldn't have made me shake so bad I would still be on it. If I switch meds I am not sure what to try next.
Are you feeling any better?
If you can get past the headaches (have you tried Tylenol or Motrin to help?)...remember that it's very possible you will need a higher dose...so don't be too ready to call it quits yet.
You would want to exhaust ALL possibilities with the Lexapro before starting over with yet another med. Your dose is on the low side of the spectrum. When I was on Lexapro, I ended up on 40 mg a day.
Just keep that in mind. Don't start thinking in terms that you are going to have to start again with a new med. You've tolerated the Lexapro pretty well thus far...and yes, headaches can be a common side effect, they will subside.
I have taken some Advil on a few occasions, along with trying to sleep them off. I hope the headaches go away. I am not sure about increasing the dose. I don't want my tremor to get too out of control. I am staying exhausted on Lex. I wake up tired & ready to go back to bed after sleeping all night. I think Lex is more sedating than Zoloft. That is my guess or at least my experience. I am at 3 weeks on Lex. I can't tell a big difference with my anxiety. Do I still need to give it some time? I actually feel more depressed. I hope it all gets better soon.
Sorry to hear you haven't had much luck with the Lexapro yet. I thought your hand tremors weren't being exacerbated by the Lexapro? It seems, overall, the side effects are much less severe than the ones you had on the Zoloft?
I would definitely give it more time. Remember, the typical time period is 4-6 weeks. As for the dosage, you could speak to your doctor about SLOWLY increasing your dose to see if that makes a difference. Just my opinion, but I still think, when a person has already invested a certain amount of time and energy on a med, it's worth it to again, exhaust all posibilities with that med before moving on. You also have to remember too, that for some people, this process takes a bit longer.
Every doctor I've ever dealt with has always said to be fair, a person should give each med at least 2 months before making any decisions about its effectiveness, unless of course, there are side effects that are just too much.
I hope you start turning the corner soon, for your sake.
Yes, tremors are being exacerbated by the Lexapro. That is one reason I don't want to up the dosage. =( I don't understand why am I getting more intense tremors on SSRIs, but it is better on Lex than on Zoloft. I am having less side effects on the Lex, but I feel lethargic. I feel more depressed, too. I am not sure if that is a start up side effect or not. I think the Zoloft helped my anxiety & depression better but I couldn't handle the tremors on it. I will continue to stay on the Lex & hope it will fully kick in. Thank you for your help.
Sounds like a plan. I have my fingers, toes and eyes crossed this works for you sweetie. I imagine you're getting frustrated.
Hey, even if the Lexapro isn't the answer, there are still options.
Hang in there!!! Big hugs!
Thank you!!! I will check in from time-to-time to fill you in with my progress. I am not giving up on the Lex. Hopefully it does work, but if not I will probably look into Paxil or Viibryd. BUT I am not going to worry about that until I know for sure if the Lex is going to work.
Thanks again for your help. Hugs to you, too! =)
I have been reading your posts and am
hoping you start to feel better soon. I
took Effexor in the past and it caused
tremors in me but they eventually went
away. I am on zoloft, abilify and neurontin
now and doing well. I tried lexapro in the
past and had horrible side effects and
little relief which just goes to show that
we all respond differently. Zoloft works
pretty good for me but it wasnt until we
added a small dose of Abilify that all
my depression went away. The Neurontin
is a mood stabilizer and helps with
anxiety and sleep. Anxiety is my biggest
problem but my pdoc gave me Xanax to
help during really bad times and it works
wonders. I have read a lot of good things
about lexapro and may even consider
giving it another shot in the future. I
hope you will keep posting - I wish you
Thank you! I wish I could handle the Zoloft, because it helped me better than the Lex. I have fewer side effects with the Lex, although still apparent (headaches, tremors), but I am not getting the results I had with Zoloft. I actually feel more depressed. I am not sure what that is all about, but hopefully it will fully kick in soon & I get positive results. If not I will try something else. I am deteremined to find the right med for me.
Are you happy with your medicine? I know you said you'd consider going back on Lex. How come? It sounds like you have your conditions under control. That is great.
You wrote "When your entire body is jerking & you can barely hold a fork to eat then it's hard to stick it out but I did for 4 weeks. The excessive tremors subsided once I stopped the Z. "
I took Celexa for months before the constant yawning and jaw trembling stopped. They said jaw trembling wasn't a symptom but it occurred both times I was on it so I have my doubts, btw.
4 weeks really isn't long but if the side effects were impossible to live with, that is a different story.
Just started reading what you were going through. How are you doing now? I am debating what medicines to go back on. I deal with GAD and SAD, and now depression. I was on Zoloft years ago, but went off due to certain side effects I didn't like.