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Avatar universal

Please help, don't know what's going on...

i have had anxiety attacks for  many years. Usually only a few a year but they were pretty heavy (including passing out in some cases). i had a relatively "normal" life though. My doctors put me on Celexa and i had a trememdous psychotic reaction. i now have fear all day. i stopped the drug after a week (only took 10mg a day) and the symptoms have subsided a little, but i'm still highly anxious all the time.i'm far worse than i was Trying to use a little xanax here and there but i don't want to get addicted. What happened to me and can i get rid of this fear without going on another drug? Is there any hope? i know now i should have never done the celexa, i am highly sensitive to meds.
Please help.
15 Responses
242532 tn?1269550379
I would ask your doctor about a limited time use of klonopin to get your over this hump. It is benign, strong enough, and will handle your anxiety.
Avatar universal
Frodo, I have alot of experience with what you describe so I think I can be of some help. Celexa is a selective serotonin reuptake inhibitor (SSRI).  These drugs increase the availabity of serotonin and have been known to cause serotonin toxicity and in some cases serotonin syndrome (a group of symptoms including hallucinations, mental confusion, anxiety, nueromuscular (muscle twitching) and autonomic nervous system problems (fever)) which has just recently become recognized in the literature. YOU MAY NOT HAVE THIS BUT If you had a psychotic reaction it may be the result of serotonin toxicity.  What happened to you and can you get rid of it without going on another drug: to treat a drug reaction like this (excessive amounts of serotonin in the synapse) the only drugs available are benzodiazepines (like xanax and ativan) to releave your anxiety or beta blockers (like proprananol that also blocks serotonergic receptors (they block the effects of serotonin) or cyproheptadine (an antihistamine that also has antiserotonergic properties) betablockers and cyproheptadine essentially do the opposite of what the celexa was doing.  BUT drug reactions like the one you describe are not usually treated with drug therapy unless they are particularly severe (for example, if you had a 105 temperature or your blood pressure was dangerously high-in general if your condition was life threatening).  For your symptoms to go away completly waiting for the drug to be eliminated from your body may be the only thing you can do (but of course ask your doctor).  The half life for celexa in most patients is 36hrs.  When will your symptoms go away? I do not have any information specific to celexa but I have heard from patients that were symptomatic for up to to two months with other SSRIs.  If you have three or more of the follwing symptoms coincident with the addition of a serotonergic agent (like celexa) you meet the diagnostic criteria for serotonin syndrome (for better info see SSRI-induced serotonin syndrome: Lane & Baldwin, 1997): mental status changes (confusion, hypomania), myoclonus (muscle twitching), aggitation, irritability, hyperreflexia, diaphoresis (excessive sweating), shivering, tremor, diarrhea, incoordination, hyperthermia, pupil dilation, hallucination.  If this is what you have I WILL BE VERY INTERESTED to find out why you had such a response to such a low dosage- usually serotonin syndrom occurs as a result of a drug interaction (concommitant use of extacy, cocain, amphetamines, MAOIs, several other medications that saturate cytochrome isoenzymes responsible for metabolism of the drug).  Renal or hepatic (kidney or liver) impairment may increase plasma levels of the drug but this is probably not the reason for the hypersensitivity.  Do you have a history of using extacy or LSD? the reason I ask this: in rats they have found a sensitization effect (that is once serotonin syndrome has been induced, it becomes easier to induce it a second and third and fourth time.  It has been noted that people who have experienced serotonin syndrome from a multiple drug-drug interaction, may not be able to resume taking only one of the drugs.  I HOPE THIS HELPS, PLEASE ASK IF YOU HAVE ANY MORE QUESTIONS.  For more information about Celexa and a list of symptoms like the one I described go to www.rxlist.com enter search criteria "celexa"
Avatar universal
Thank you very much for the input, i really, really appreciate any info i can get on what is going on. My fear response has really been exaggerated and i can't seem to turn it off. In response to your questions... no, i have never used LSD or Extacy. As a matter of fact, i don't use alcohol, and outside of smoking pot 3 times in my life years ago, i am pretty much drug free. i started the Celexa at the end of October, and only was on it for a week. i had to stop, it was hell. Like i mentioned i only took half a pill (10mg). When i was on it, i did feel some flu like symptoms (kinda of fevery, shaky legs, nausea). i guess i've been off it for about a month and a half now. Since then, i've improved a fair amount. i don't think i have any of the symptoms of seritonin toxicity you described, or at least not many. Right now, i just have alot of fear. My heart races afair amount of the day. Especially when i wake up. i have been taking xanax (.25 mg 4 times per day) and it takes a slight edge off but it's no total relief. i'm afraid to take much more, as that i know it can lead to addiction. i don't want that too, but there's nothing else i know of that helps. Physically, i feel pretty well, with the exception of the usual symptoms of anxiety. The less i am able to think about it, the better i feel. i think that the drug itsself may not have had anything to do with it, but i don't know. And i don't feel it's a completely life threatining situation, although i wonder sometimes how i will live the rest of my life with the constant fear. Like i said in my post, i was a guy with a few panic attacks a year (albeit serious ones) and they did start to inhibit the quality of my life; i avoided certain situations or was made very uncomfortable by them. That's why my therapist told me to try an SSRI, so we could stop the attacks and work on my issues simultaneously. Now, however, since i took one, each day is hard. i just don't know what i can do about it. i'm afraid that once your mind feels a certain way, like when i was on Celexa, that it can't snap back to "normal". Is it possible? Is there hope? and what things can i do? What happened to me? i'd really appreciate another response.

Thank you so much
Avatar universal
Maybe the forum doctor can explain the sudden worsening of your anxiety. If you are asking what can you do to feel more normal without more drug therapy: Hasnt your therapist mentioned cognitive behavioral therapies (they have showed some promise in treating panic disorder, social phobia, and generalized anxiety disorder-these what you have or just panic disorder?). I should be able to answer any questions you have about CBT so feel free to write back :)
Avatar universal
Thanks very much, again, CCB, for writing. If the forum doctor reads this, please read my first post above and repond. i would surely like a response from him, please.

i don't think my therapist is a trained CBT therapist, though when i asked she said we are working with some of that technique. i have enrolled in an 8 week workshop at the local hospital where they use that method. It starts in january. i'm looking forward to it, as that i need answers. i've heard good things about CBT, and i hope with all my heart it holds some answers. i feel like this problem i'm having is almost like a post traumatic incident from the celexa. Like it brought my mind to a new place, new level of fear, and it was so bad i can't seem to shake loose. Does that make sense? What things can i do or how can i get past it all? Again, your answers and those of the doctor are extrememly important to me, and i thank you so much.
Avatar universal
I had similar effect from small dosage of proxac. I used quantum physics philosophy to question the validity of the signals I was recieving about reality. I was concerned that I would never retrieve my previous lucid state. It worked to my advantage as it created a break of significant strength to what went before. This worked like ect shock therapy to stop relating stimuli to previous experience. This is where panic comes in. You react to stimuli from expectation and this creates the body state. Use the exp. to face all instances as an amnesiac to do wonders against anxiety. You have faced the worst experience a person can face and lived. The fear of losing control is the #1 phobia. The ssri's are the cause of the psychosis and the expectation of permanent imprinting of your mind by this is the source of the increased panic. It will pass and you will be better for it if you work at it.
Avatar universal
Frodo, Can you distract yourself with excercize? In addition to its value as a distraction strategy strenuous excercise (for 20 or 30 min) may also provide some physiological benefits that relate to overactive adrenal response (specifically with panic disorder) and tends to regulate breathing -this is if you are too fearful to try other meds-for some reason I got that impression-otherwise sure it might be helpful for you to try some other benzodiazepines (klonopin like the forum doc suggested, or ativan, valium, serax, etc).  Hope this helps :)
Avatar universal
Thanks so much guys, all of you, as i said before i so very much appreciate the help. Dgull, can you reccomend any good reading material that helped you?; sounds like a good idea, and i'm very interested.

CCB, yes i work out regularly, and have also been riding my bike several times a week. Really hitting it all like mad. It does help a little, thanks. And actually, i have been able to take a small dose of xanax (.25mg 4 times a day) and it helps a little as well. i don't know if this is enough, as that it only takes the edge off. Do you or the Doc think there is a better drug solution that won't freak me out? i like the xanax because i can control it and it makes me feel normal, just relaxed.

The real problem lies in when i start to "remember" what happened. Seems my whole body remembers as that i get really shaky and fearful. My hope is, that this was like a bad acid trip or something (though i've never been on one) that lasted a week and eventually my mind will heal. i've narrowed it down to the scariest thought for me, and that is sometimes i feel trapped in my own head with these destructive thoughts that the drug induced. i've learned that the toughts can cause severe physical symptoms. Nothing suicidal, or anything, but just terror at remembering how the drug made me feel and thinking i have no control over the negative thoughts. Kinda like a mental clausterphobia. Does that make sense? i know now, i should have never taken the SSRI. i don't feel i was that bad off to start with, and i'm obviously highly sensitive to meds of that type.

Guys, all 3 of you, thank you so much for the responses!
Avatar universal
Well Frodo, I hope that the workshop that you start in jan will help I wish I could help more but your doing everything that I tried for myself already.  The reaction that I had to an ssri was similar to yours except that I was also having hallucinations and confusion.  These symptoms for me lasted for about a month, my anxiety is worse than before but is gradually going away too, I was too afraid to take any meds though and still am for now.  So everything your saying makes perfect sense to me because i didnt think it would end either but hang in there and good luck :)
Avatar universal
Thank you, CCB, again very much. It's been about a month and a half now since i stopped them and i'm still really scared. Last souple of days my throat stated tightening and now i'm worried it will swell up. This negative power of the mind is so scary. Do you consider yourself a highly sensitive person? i wonder because i believe i am and that's what causes these things in my mind; i take everything deep inside to heart. Your words and those of the others help me greatly and i look forward to coming here and reading a new post to mine,but i also fear like i'm going to be the "unhelpable one". Though i have to have hope. The most i get is from my family friends and reading positive stories like yours that lead me to believe i can do it.
Avatar universal
I read deepak chopra's   timeless mind ageless body.   This can really help as there is very counterintuitive logic contained and mind is your interpretation of stimuli not empirical response to it. Like the stoic philosophers of old you can have a pleasant state of mind even in adversity. I of course am still learning this and will do so till I die. I was lucky and did not freak when I quit cold turkey. Prozac is a slow purging drug though and some others are more harsh. I believe that I had a neurotoxic reaction and therefore my mind did not need the drug. It needeed to get away from it. Look up meditation on  the net and use it to control breathing and to accept the world as it is.
Avatar universal
I feel that taking Zoloft made me suffer more than I had to.  It was after two weeks on the drug (50 mg/day)that it "kicked in" and I suffered dearly.  I had my first true panic attack about three weeks prior and had no idea what was happening to me.  I was so traumatized by the feeling that I was going to die that it became my only thought.  I went to the doctor for the first time in 13 years and he hardly examined me.  He wrote prescriptions for Zoloft and Klonopin and sent me on my way.  The Klonopin was great for calming me down, but it left me so sleepy and lightheaded that I had to stay in bed for two weeks, after that time, the doctor took me off the Klonopin and suggested I up my Zoloft dosage to 100 mg/day.  Two days later, I had three panic attacks within a 12 hour period.  I suffered extreme feelings of depersonalization, I was vomiting for the first time in years, I could not eat because everything gagged me, I had to urinate every few minutes, my mouth was dry as powder, I could barely walk.  It was my second day like this that I stopped taking the Zoloft, but since it takes a few days for the drug to get out of your system, I continued to suffer.  I slept only about 20 hours over a 6 day period.  I had the most horrible, uncontrollable thoughts about dying.  I would close my eyes and see all sorts of horrifying images.  When I did go to sleep, I would wake up shaking all over, and I also got the "internal shakes."  I felt like I was going to jump out of my skin, and I hallucinated once.  And what did this do to me?  It only increased my fears and anxiety 1000 fold because I DID NOT KNOW WHAT IT WAS.  I went to a new doctor and went back on Klonopin and have been on it since September and now I am doing much better, but that experience on top of my prior experience left me in such a state that I ended up lying in bed for months, crying all the time, and worrying myself sick.  It wasn't until about a month ago that I found a website that gives a thorough list of possible side-effects of these medicines and I found out that Zoloft can cause all of those things I was experiencing and many, many more.  If I had known then what I know now, I may not have suffered as much and could have been on the road to recovery long before now.  It makes me so angry how uninformed we are as patients.
Avatar universal
dGull- thanks again for your help, i greatly appreciate it. i will check into the stuff you recommemded and am really glad to hear it sounds like you have found a bit of a solution for what happened. Hopefully it will help me as well.

Noonie- thanks for sharing your story. i'm so sorry to hear what the stuff did to you; i completely uunderstand. No one really told me other possible reactions to it. i don't think my panic condition was life threatining so i don't think a med that intense was the solution. With some anti anxiety stuff like Klonopin or Xanax and perhaps CBT, i think i would have been fine, and hopefully, when i get out of this current state (and from everyone's support here and other places, i think i will) that path will help me greatly. As i've said, i was a normal guy with panic disorder as my problem, not someone who has a serious mental health concern. Through my experience with Celexa, i have questioned my sanity, my reality and have felt terror i have never know. Yet the doctors still say things like "oh, don't read all that negative **** about the ssri's, they're really great" and "well, the problem is really with you and not the drug". That's the kind of stuff that scares the hell out of me as that i've never questioned anything about me before this. When i took the Celexa, i thought it would be like Xanax, only i'd start to be very happy, too, and not think about my Panic attacks. You know, like unobtrusive. That was certainly not the case, and no one said anything about it before hand. As a matter of fact,they encouraged me to keep taking it even though i flipped out on my first night on it. Thank God i took control and stopped after a week.

i am very very encouraged by the stories of people that have had this kind of experience and come out the other end. It keeps me going. When i feel that there is nothing wrong with me and this was just a bad trip i'll recover from, i do much better.

Thank you guys, so much, for responding.
Avatar universal
Frodo, I had a very similar reaction after only two days with Celexa.  Much worse than before.  Fear, visual disturbances, gastrointestinal problems, and much more.

I orginally went to the doctor with hot flashes and having never had a real anxiety attack.

I now feel anxious constantly.  My vision seems "hazy".  My sleep patterns are out of whack. It's been 2 months since I took Celexa and I am afraid this is permanent.

If you've discovered answers, can you share with me what might have helped you?  My e-mail is ***@****
Avatar universal
Hi, everyone,

i was very surprised, when found this - i thought it is only me such crazy person who has immediate reaction on any kind of ssri.
I even had an idea, that it is because i am not an american (i am russian, so excuse my bad english, please) and probably i have different metabolism of this drugs in my body. I can feel some tension even from st.john wort - the herb!! Ginseng and all other stimulants - are no-no for me - i feel dizzy and flu-like on it. And i had all of that symptoms on ssri(paxil, prozac, zoloft), which was described in this thread - depersonalization, panic, fear - and alot of physical stuff. This happened from smallest doses (1/4 of minimal) and as soon as next day.
Recently my new doc (who is also professor of neurochemistry at Stanford) told me, that there are not only one serotonin in our body - they call them "good" and "bad" serotonins, and ssri are sometimes not enough selective, so they work on "bad serotonin" too, together with "good". It could be, that i (and you) have depletion of good serotonin and exessive "bad" stuff. So, before "good" is rising enough - "bad" is already toxic...
My doc tried "to work from other side" - work on GABA. Obviosly, we are short on gaba, because of it benzodiazepins are so good for us, they work on gaba receptors. But they are addictive and cause memory blocks (which i have alot). My doc suggested Neurontin (gabapentin), which was used before for convulsions. I am thinking about it now, cause i am fobic to any medications this time.  But from my research  - it looks REALLY innocent, not addictive, almost no side effects, and even has no toxic overdose - so i am going to try it... possibly...
It was very nice to realize, that I am not alone! Thank you all guys very much for sharing experience, hope my 5 cents will help somebody too.
p.s. does anybody know how to explain flu-like syndrom? It bothers me a lot lately. I am less anxious, when i do know what is happening and how to control it. When i don't - "mental clausterphobia"(such a perfect name for this state!) happened.
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