Trying to start Celexa

[LostBoy]

I am a 33 year old working male.  About 16 months ago, I began exhibiting signs of anxiety (attacks and persistent symptoms).  For the past year, I have experienced persistent and extreme fatigue and leg weakness.  Occasionally, I would have an "attack" (of course at the most inopportune moments) of lightheadedness and feeling extremely faint.  This event would quickly escalate to palpitations and the sudden urge to "get to a hospital" or seek help (seemingly classic symptoms of an anxiety attack).

All blood work has come back normal.  I went through four months of (torturous) CPAP therapy which provided no relief (of course, I have never known of anyone to emerge from a sleep lab without some kind of "label" and a CPAP device).  As a seemingly "last ditch effort," my doctor prescribed Celexa - 20 mg.

I have had the worst time trying to get started on this medication.  I understand that this drug is normally highly tolerated; however, my reactions begin within one hour of taking a 20 mg tablet.  I become extremely weak and tired (to the point of not getting off of the couch).  Feelings of skin tingling, disconnectedness, nausea, jitteriness, and fast heart rate persist for the next 8-9 hours.  I have had a great deal of difficulty sleeping, even after trying to take my dosage in the morning and evening.

Needless to say, after having a go at this medication twice, I have quickly ceased both times after only one dose.  I understand that these SSRIs take time to "kick in" (4-6 weeks), but that just doesn't work with my job.  I need to travel quite a bit, we have a baby on the way, and "laying in bed" for 4 weeks just can't happen.

My question is bifold.  Have any of you encountered primary anxiety symptoms of severe and debilitating fatigue (before medicating), and if so, did you find a medication/resolution that helped you?  To those with experience with Celexa, did you experience these debilitating symptoms in the first few doses?  How did you deal with these effects?

Thank you for this friendly forum, and God Bless.

[Skammy]

Never been on Celexa, but the weakness you talk about is VERY common. When having an attack, I feel like my legs are jelly and my arms weigh a ton. If you're not comfortable taking the Celexa anymore because of the side effects, talk to your doctor or psychologist about another option. I've had nothing but success with Lexapro (until recently) and have had absolutely no side effects. Sometimes you get a little foggy but that's a lot better than having full blown attacks throughout the day. On the other hand, everyone's different. Here's the catch with anxiety. There's no cure. You have to act as a guinea pig for months, trying to find the right medication/treatment. It's going to suck, but once you find what works, you have to stick with it and hopefully things will get better.

[insights]

I have had the worst time trying to get started on this medication.  I understand that this drug is normally highly tolerated; however, my reactions begin within one hour of taking a 20 mg tablet.  I become extremely weak and tired (to the point of not getting off of the couch).  Feelings of skin tingling, disconnectedness, nausea, jitteriness, and fast heart rate persist for the next 8-9 hours.  I have had a great deal of difficulty sleeping, even after trying to take my dosage in the morning and evening.

The start dose is too high for you. Explain your difficulty to your doctor and ask him/her to prescribe 10mg tablets. Also ask if you can take only half for the first 7-10 days, if necessary. A script for one of the benzodiazepines (Ativan/Klonopin/Valium/Xanax) would help too, but many doctors are reluctant to prescribe them so you may not get it.

Ian

[Betsy]

I agree-the start dose is pretty high. I think I started on 5mg and gradually worked up to 20 over the course of 6 months or so. It did help me, but it wasn't fun to go off of-it is very habit forming.

One option would be to ask for a "take as needed" drug like xanax...you would only take it when you were having a panic attack, not as a preventative measure. If your main problem is panic attacks, this works pretty well (at least it did for me). But if you have general anxiety disorder and feel "on edge" all the time, a daily medication might work better.

I would also highly recommend some cognitive behavioral therapy-it really helped me with both GAD and panic attacks.