At 20mg a day the dosage could be raised because your not at the max dosage for Celexa.
On the other hand after 4 weeks at this moderate dosage of 20Mgs you should have noticed at least a small lift in your symptoms. You say this is your first antidepressant so don't panic yet. My first antidepressant was Serzone and it also did not work for me.
You also have the option to try an SNRI rather than another SSRI. Many people (Including myself) Find SNRI's such as Effexor to work much better at dosages in the 175 Mg to 300 Mg a day range. Below 175 Effexor acts more like a weak SSRI so keep that fact in mind when dosing.
There is also Pristiq and Cymbalta. They are also SNRI's, but after trying all of them for months I found a Moderate to high dosage of Effexor XR to work best. TIP: They have a generic Effexor.....stay away from it. Many reports from many people are saying it is not near as effective as the name brand.
I take 2Mgs of Klonopin a day, but my system is so used to it that it no longer causes me to be sleepy.
Also keep in mind that you have not even touched the tip of iceburg with antidepressants. If you keep finding yourself resistant to all antidepressants then there could be a chance that your really Bi-polar 2 or Bi-polar 3 which will require a different combination of meds to reduce symptoms.
When I say Bi-polar I don't mean you get massive lows and then massive Euporic highs. That is Bi-polar 1 and they only make up 10% of Bi-polar sufferers.
You have a very long way to go before throwing in the towel. There's still a ton you haven't tried so don't give up yet. Celexa just might not be your drug. It happens. Prozac does nothing for me, but I know many that like it. Just depends.
Good luck and make sure you have a good Psychiatrist not a regular MD.
Can I switch to anther right away or do they have me taper off. I also am worried about the Klonopin. Could it be making me feel worse too? Will takin an SSRI that works lead me to not take the Klonopin. The Klon. was prescribed to help with the side effects of the new prescription of Celexa. I didn't need it in the beginning, but now I feel I need to take it. What is going on, am I getting addicted to it already? Also, if they do switch me to another SSRI, will I have to wait up to 4 weeks to see results or will it be faster since I have somewhat the same mechanism already in my system?
Slow down and don't panic. Right now your on low dosage Celexa and Low dosage Klonopin. Nothing to fear except the depression and anxiety that the Celexa is not working to control. Physically speaking your safe so try not to give in to a panic state that is only going to make your anxiety worse.
I am going to take a wild educated guess that your Klonopin dosage is 1/4 to 1/2 mg a day? Look at me, I take 2mgs a day and I am not addicted to the drug. This isn't Xanax were talking about and while Klonopin can "have potential" for addiction this is always at much higher daily dosages like 4 to 10Mgs a day. It is also MUCH less addictive than Xanax.
As for switching the Celexa for another antidepressant. Most Psychiatrist would have you cut down to 10Mgs a day and then just make a fast switch to another. Some P-docs like to wean people off for about a week before introducing a new antidepressant. It just depends on the Psychiatrist.
My P-docs alway just switched me over fast even before the former drug was out of my system. I never had a problem with that. Heck, at one point I was taking 300Mgs of Effexor and 30Mgs of Lexapro a day as regular treatment. In some cases SSRI's and SNRI's can be combined. As for taking two SSRI's at the same time this is a No No and shouldn't be done. (You can safely mix SNRI's with SSRI's) that's how resistant I am to medication. Look at me, I'm still alive.
I must now take 5 different meds just to keep my Severe Depression in check. If I told you all of them you would wonder how I'm even alive. Try 1,350Mgs a day of Lithium. That's enough to make a Billy Goat Vomit, but my kidneys filter it out so fast it hardly has a chance to work. The antidepressant I take is rare and is very powerful. The side effects are not fun.
I'm just trying to make you feel safer and let you know that if I am still alive with all this that you will make it also. You will feel better, it's just going to take some further med adjustments to get you back to feeling normal.
Remember, Psychiatry and psychotropic meds for depression are not an exact science, but rather an art. Now let's just hope your psychiatrist is a good artist.
Wow, you seem to know your meds. My aunt started on Zoloft 10 yrs ago and thats all she ever took. I just thought this would be an easy thing. I was not depressed until now. I had acute anxiety issues that started 5 months ago. This whole breakdown came out from left field (well somewhat). I heard SNRI can cause more anxiety than the SSRI? I wake up at 5 am in a sweat and then the wheels start turning in my head. That's when I feel I need to take the Klonopin (.25mg). Which dosen't help and then I take the other half a few hours later, then lay in be all day feeling depressed, sick and uncomfortable. At around 3 or 4 I can't take it anymore and take a .5 mg and then feel better. This is just happend in the last 3 days. I can't live like this. There has to be some SSRI/SNRI that will help... I don't mean to sound repetative sorry. So does your Lithium work for you then? Did you happen to know if they switch me will it be like starting all over or does it pick up where the last one left off?
Unlike Xanax, Klonopin (Clonazapam) has a very slow onset of action and a slow off set of action at any dosage.
My Severe depression first manifested itself as Generalized anxiety and panic attacks with racing thoughts and such. It was not until many months later that the devistating symptoms of a full blown Major Depression landed me in the hospital.
I was put on Zoloft 150Mgs and it worked well and I got my life back. For about 4 years I got my life back, but unfortunatly the Zoloft even at 250Mgs a day slowly stopped working. I was then put on Effexor XR. Great drug and it put me back in remission for about 4 years before it to started failing. On and on this cycle went and 20 years later it is still happining only now my antidepressant is augmented with the Lithium which helps a lot.
When it comes to treating severe depression there is more than one way to skin a cat.
I got back from the doc and he upped my dose from 20mg to 40mg. He said to keep taking the Klonopin as it is a band-aid until the Celexa kicks in. I hope he is right about it kicking in.
I think he's making the right move for now. He doesn't want to bounce you to another antidepressant before he feels Celexa has had a chance to work.
I know you said it's been 4 weeks, but for some people it can take 6 weeks before the drug is in full effect. Not to mention that you were only on 20mgs. Now your on 40Mg and a full 6 weeks on 40Mgs will be the deciding factor. After that if your still not feeling any better then your P-doc is going to have to switch you to another antidepressant (an SNRI in my opinion) Effexor XR maybe.
Effexor XR is the number one selling antidepressant in the US. Mostly because it often works when other drugs fail to produce a response. Pristiq and Cymbalta are also SNRI's, but neither did nothing for me except Cymbalta made me worse.
Some folks like the Cymbalta, but the majority go with Effexor XR.