waiting for lexapro to work again, hard to go to work

[2sungo]

Hi guys,
I had an anxiety attack last week, not quite a full blown panic attack (have had those in the past) after many years of no problems.  I had gone off lexapro over many months, then a couple of weeks ago started taking crumbs of it and sometimes klonopin for sleep as some stressful stuff happened and I felt down and or stressed at times.  Nothing I couldnt deal with, but then last week I got sick, took cipro, after I took the second cipro I had waves of anxiety sweep over me (I had also had tea, which I stopped cold turkey after that) and didnt feel right all day.  I took 5 mg lexapro, and .25 klonopin that evening, upping it to 10 mg and .5 respectively after seeing a doc last Saturday.  I have sometimes taken .25 additional klonopin in the morning, b/c that is the worst time for me. Trouble is I am so groggy and my job starts early and I have to interact with people and drive there.  I am taking some time off but don't want to lose too much time.  I suspect I am having ssri intitial anxiety on top of what I already have, and probably depression from either the disorder or the klonopin. I just want it to work faster, and in the past I remember lexapro being rather gentle when I got back on it again.  The last time I had a real bad time was a dozen years ago but I was able to recuperate over two months of vacation, but now I am in the middle of the work season so that adds to my anxiety, even though I know I can take time off if needed.  At times, particularly towards evening, I sometimes feel better. What is the soonest I can hope for some significant improvement in the morning grogginess and general anxiety/depression? I have noticed lately that my stomach is quieting down, less gurgles/pain/discomfort than before, if that is a sign of hope.  Thanks!

[insights]

I had gone off lexapro over many months, then a couple of weeks ago started taking crumbs of it

A waste of time, and possibly counterproductive. Antidepressants don't have an immediate effect in the way benzodiazepines, or painkilers, do. You need to take them daily for some time at therapeutic doses to get any benefit. Taking small occasional doses just sensitized you for the side-effects.

I suspect I am having ssri intitial anxiety on top of what I already have, and probably depression from either the disorder or the klonopin.

This would be my guess too.

in the past I remember lexapro being rather gentle when I got back on it again.  The last time I had a real bad time was a dozen years ago but I was able to recuperate over two months of vacation, but now I am in the middle of the work season so that adds to my anxiety, even though I know I can take time off if needed.

There is growing evidence that antidepressants can produce more severe, and sometimes different side-effects the second time they are started. Why is unknown. It is to early to tell whether this keeps escalating every time they are resumed, but it is possible.

At times, particularly towards evening, I sometimes feel better. What is the soonest I can hope for some significant improvement in the morning grogginess and general anxiety/depression? I have noticed lately that my stomach is quieting down, less gurgles/pain/discomfort than before, if that is a sign of hope. 

That is impossible to answer as everyone is different, but it is likely to be a little longer than previously. The improvement with the stomach suggests that at least your enteric nervous system is adjusting, so hopefully your brain will soon too.

Ian

[helplessdancer]

When I returned to Lexapro after being off for a few months, it took around a month for me to start feeling the effects again, although I think I was taking a smaller does the second time if I recall. I was sure that it wasn't working (my anxiety was causing me to feel sick after eating) and something else was wrong, but it eventually kicked in. It's no fun having to wait, but unfortunately it just takes a while :/

[2sungo]

thanks for the info, I did see a local psych today who suggested switching from klonopin to ativan, but the more I read up on that the less great an idea I think it is.   I've gone off klonopin before well after the antidepressant takes effect, but ativan sounds a lot harder.  Only benefit would be if it helped with the depressive part of this.  He seems to think also that its a matter of time waiting for the lexapro to take effect in a couple of weeks or so.