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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 5 of 5. This is the beginning of the thread.
Posted by PokerPlayer on October 4, 2010, at 20:17:54
So I have pretty bad anxiety and panic symptoms, no doubt from putting my body under not only excessive psychological stress but physical stress as well (i.e. working out excessively hard to release stress, there is a point where it is bad for you if you are tired).
Anyway, I have used celexa before for anxiety and it took around 13 weeks at 20mg but it worked great once it kicked in fully.
My symptoms came back 4 months after I got off the drug, and a year has passed and I want to use the drug again.
The problem: I get massive increased anxiety at a dosage of just 7.5mg.... this is not the kind of anxiety you can ride through. At 5 mg celexa I do not get increased anxiety.
So, does anyone have any experience with this situation? Do I need to slowly up my dose, maybe 2.5mg every 2 weeks? Or can I just keep my dosage at 5 mg and that should be enough? This is just really disheartening because I tried to beat anxiety naturally but I let my body deal with this for so long that it has become so sensitive I feel its impossible to come out of if I can't even tolerate 7.5mg of citalopram.
Posted by Phillipa on October 4, 2010, at 22:09:05
In reply to low dosing ssri for anxiety, posted by PokerPlayer on October 4, 2010, at 20:17:54
I have seen a trend with my pdoc for instance to prescribe meds at lower doses. If it works at 5mg why not stay there? Phillipa
Posted by ed_uk2010 on October 5, 2010, at 13:34:18
In reply to low dosing ssri for anxiety, posted by PokerPlayer on October 4, 2010, at 20:17:54
It may be useful to take clonazepam (Klonopin) for a couple of weeks until your anxiety starts to improve on citalopram. Increased anxiety is common during the early stages of SSRI treatment. I suggest 0.5mg clonazepam once or twice a day, adjusted according to response.
Posted by glydin50 on October 6, 2010, at 23:31:44
In reply to Re: low dosing ssri for anxiety, posted by ed_uk2010 on October 5, 2010, at 13:34:18
I agree w/ Ed.
I believe, for *most* folks, therapeudic dosing is just that and is optimal for benefit.... I don't think dosing recommendations were just pulled outta the air during R & D. I also believe slowly increasing to a starting dose is not THAT much of an aid... Some do alright doing that and some docs recommend it. Mine doesn't. I believe this process just prolongs the startup effects in lieu of preventing them. Using a benzo to quell the startup anxiety is exactly what I did when beginning a SSRI. I've had one dosage increase and I used it during that time as well.
Posted by ed_uk2010 on October 7, 2010, at 14:18:58
In reply to Re: low dosing ssri for anxiety, posted by glydin50 on October 6, 2010, at 23:31:44
>Some do alright doing that and some docs recommend it. Mine doesn't. I believe this process just prolongs the startup effects in lieu of preventing them.
I think it can help but shouldn't normally be too slow eg. for Lexapro, 5mg for one week then increase to 10mg.
This is the end of the thread.
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