Citalopram / Sertraline

[ScattyPenny]

After a very long battle with anxiety, I have resigned myself to the fact I am going to have to take meds to address it. I already take propranolol and diazepam (as required when it gets really bad) but I need something that will help to combat daily persistent anxiety.

I have read lots about sertraline and citalopram which seem to be the 'go to' SSRIs for anxiety.

However, I am not depressed and I'm a bit worried about messing with seretonin levels. If I take these meds, could they affect serotonin levels permanently? If I come off them, could it trigger depression because my brain has become accustomed to higher levels of seretonin? Can it permanently affect brain chemistry?

Or ....am I being an anxious crank and worrying unnecessarily (certainly wouldn't be the first time!!)

I have posted before to see if anyone can recommend any alternatives that only combat anxiety (eg pregabalin or buspeirone) but didn't get much info. I don't suppose they are commonly used meds so not many people have experience of them.

Thanks :)

Bump?

I'm not a biochemist but as far as I understand it, they inhibit the reuptake of the serotonin so that there is a higher level available to your brain, rather than increasing the level in your brain/body the way that 5htp does. As such, you shouldn't have your levels permanently affected.

Why SSRIs and similar medications work is actually not completely understood. They raise serotonin levels but this also has a knock-on effect on other neurotransmitters eg GABA. They also massively reduce inflammation (it's recently been suggested that mood disorders are related to inflammation and this may be why they work).

Having said all that, sertraline in particular seems to be very effective indeed for anxiety although many people do find that it makes things worse initially.
I took it for anxiety years ago (and am about to again), I had a horrible initial ten days but after that I had zero anxiety and I did come off them pretty easily about a year later.

I would avoid pregabalin if possible as it interferes with neuroplasticity (ie brain connection regeneration) and is very hard to come off. It's probably worth talking to your doctor about buspirone although they may want you to try and SSRI first as it's first-line treatment.

Ah that makes sense about the serotonin.

Just not sure I fancy the 'worse before it gets better' situation. I'm going to be really busy in work over the next few weeks and could really do with hitting the ground running with whatever I take.

I've been reading up on Pregabalin and it does seem a bit dodgy. Lots of people struggling to come off it.

Buspirone seems like a good choice but apparently it's quite mild and I'm just not sure it will do it for me. My anxiety spirals in to panic very easily and I think I might need something a bit more heavyweight.

Bloody hell! Anxiety is such a pain. It seeps in to every aspect of life and eats away at you. Just wish I could feel normal rather than a churned up ball of neurosis all the time. I worry constantly and my heart is usually over 100 bpm even when resting.

A few gins and some diazepam work a treat but obviously that's not something I can rely on regularly, although it's nice once in a while just to escape my own head.

I'm glad the sertraline works for you. It must be an amazing feeling knowing that you have a medication you can fall back on when things get tough.

Thank you Max

Anxiety is an absolute bastard. You must be exhausted with it. It's so very physical and physically shattering as well isn't it!

Tbh I'm pretty nervous about taking it again due to the initial roughness but I would say if you can manage that it's totally worth it to be anxiety-free. The diazepam is a useful tool in the first week or two. I'm not working just now though and it's a lot harder if you are.
But I don't mean to put you off, some people don't struggle too badly with it, it's very individual.

As a non-medication option, a lot of people seem to do very well with a book called Dare. There's an attendant fb group and some of the stories are very inspiring.

I do think generalised anxiety is the hardest to tackle though. How do you push yourself to overcome anxiety when your heart is racing simply sitting in your own living room?

All the best to you, I really hope you get this sorted x

I'm about to enter week 4 of Sertraline and I've had a far better few days though I have to say I felt absolute shit on it at first to the point I started a thread about it. I anticipate that feeling returning on and off too from what others have said about the early weeks. But, the better days are so much better. I've also been on pregabalin before although not for anxiety - but I didn't find it affected my mood at all and I was on it for months.

Hi OP,

So sorry to read you also suffer with bloomin anxiety!

My consultant out me on Duloxetine and Quintepine to help me with me as the combo you suggested didn't help me (that was prescribed by my GP). They really help me, I know everyone's different though of course.

Good luck lovely x

Max - Yes it is a bastard, and exhausting.I have tried various self-help books and whilst they change my mindset for a short while, the anxiety always manages to win. I have also tried hypnotherapy, yoga, mindfulness, CBT, seeing a counselor and seeing a psychologist - all to no avail (very expensive but ultimately fruitless). I will look up Dare though, it's worth a try. Thank you so much for your advice. It's reassuring to know that Sertraline works for you and I will keep it in mind for when I'm off work for a bit.

Dljlr - Interesting about the Pregablin, it definitely sounds like one to avoid. I'm glad you're having better days now. It must be such a relief.

Twittle - Did you mean propranolol and diazepam didn't work or pregabalin and buspirone? I'll look in to the ones you are on.

Thank you all for the advice and kind words x

Apologise should have made it clear! sertraline and citalopram didn't help. I know they do help some people though but for my anxiety it didn't help.

I have been on diazepam before and it does help for those intense moments but my consultant said it shouldn't be prescribed as an on going medication as it's essentially just a tranquilizer.

The initial anxiety spike with sertraline is entirely subjective, in my case it lasted 2-3 days but fully worth it PND-wise.

I still have generalised anxiety but attend CBT and go on. Physical symptoms such as palpitations, shortness of breath etc (I've had full panic attacks in the past so these are very dangerous as leading to hyperventilation) are much, much less.

I'd give it a try.

Hi, sorry to hear you are suffering with anxiety, it is a good thing to consider medication. After suffering with anxiety for the past 6 months I am now on diazepam when required and sertraline 100mg daily, after initially refusing medication.
It is important that you realise medication is of great benefit but is better if you receive some counselling alongside. The waiting list is long but worth it.

Please don't worry about taking meds. I felt the same way - somehow weak and defeated - but that's all part of the anxiety and mental health condition. I'm on Citalopram and have been for years now on and off. It has been a life changer for me. Took a long time to find the right dose and kick in, but thereafter was a godsend.

There's no joy to be had in clinging to the walls in your own house feeling like the sky is going to cave in at any moment. I'm totally open with my family about it and they're great. The only advice I can give is to make sure you and your GP are on the same page and to have regular appointments (once a week/once a fortnight) so that you can be properly assessed, supervised and supported until you find the meds that are right for you.

Good luck, sending big hugs, and stick with it! Lots of support here whenever you need it.

I have anxiety and take old style anti depressants dothiepin and buspirone, propranolol 160mg, pregabalin and diazepam (when I need it). With the exception of pregabaljn (which I've been in for 10 months). I've been in these meds for nearly 20 years. Ssri antidepressants didn't suit me at all, but I know plenty of people who they've worked well for.

Depression, anxiety and panic attacks are 3 very different things.

I couldn't function without them, I hate that I am dependant but know I need them to get out of the door.

There is a website called No More Panic with a forum for all kinds of MH issues including medications. It's worth a look. Good luck op.

Thanks Twittle, yeah I try to use Diazepam sparingly although it has been a Godsend at times!!

PleaseTry, I will definitely speak to my Dr about them. Could always use Diazepam in the interim if things get bad for first few days/weeks.

Consistent, did you find the Sertraline useful?

Sicario, thank you, it's good to know I'm not alone in this. It can feel quite isolating at times. I'll make sure I speak to the Dr regularly once I'm started on something.

Fiery - Wow that's a hefty amount of meds your on. Is it difficult to tell which ones are actually doing the job? If so, which do you find the most useful?

Thanks again all x

Hi, I am just reading an old post of yours from 2018 regarding the medication Sertraline, I was wondering if you did end up taking it and did it help, were there any side effects? Your post hit home a lot with what I am experiencing day to day!

I have anxiety and depression. I've been taking sertraline since July last year, and I think I was really sleepy the first 2 weeks and then okay since then. I feel much more able to cope with life and my anxiety has reduced so much. I have also had CBT and some counselling since then. I take 100mg sertraline but was started on 50mg.

Oh I've just seen this was an old post, it's still relevant to so many people though.