Dose change

[Mongea]

One week into another dose change and another decrease in my Ativan. Anxiety is creeping in today. Is it normal to have side effects return every time you increase?

[Kkimm]

Hi Mongea

In my case yes, I think I had both an increase in anxiety and some periods of feeling amazing, or in fact unnaturally high but I always quite enjoyed that side effect.

You seem to be coping with the decrease of Ativan very well

Hang on in there, you will get there

Kim

[Mongea in reply to Kkimm]

Good morning Kim,

How long after dose changes did you typically start to feel stabilized? It seems to take a couple weeks for me.

[Kkimm in reply to Mongea]

Hello Mongea

I think it was a few weeks, say 2 or 3.

The anxiety is hard to judge due to up and down days anyway but the high episodes ended after about 3 weeks and I would therefore think that the good effects from the increased dosage were not lasting but came to see the highs as part of the unstable period and that normality does not have the up or down periods much.

I continue to feel as much if not more joy in life than I did before I was ill and certainly do not feel flat as some people describe when on antidepressants. Mine however is an SNRI not an SSRI which Zoloft is. In the UK it is usually called Sertraline. I very nearly changed to it in the first two weeks on Venlafaxine because I was finding the increase in anxiety so difficult but then I had my first good day after 10 days and hung on in there.

I think you would have found the initial side effects for Venlafaxine worse than for Zoloft as that is meant to have less side effects and be very good for panic attacks.

Mine is meant to be good for severe anxiety in GAD and at helping with menopausal symptoms such as hot flushes and I have now heard for migraine also. It inhibits the re uptake of Noradrenaline as well as serotonin so I think it is more stimulating and less likely to make you feel numb but possibly more likely to over stimulate and increase anxiety at the beginning but possibly also cause high feelings and irritability as well. I have experienced all of these.

Do you or anyone else experience periods of euphoria on Velafaxine or other antidepressants ? I am interested to hear about that.

It must be difficult for you hearing good and bad reports of Zoloft as it is for everyone first starting on an antidepressant. I think there will always be a full range of views from people who take it. This will not always relate to the drug itself but how long each person takes it for and what they do to try to help themselves cope. Use of therapy tools, positive attitude, tackling a new challenge daily, being patient and not allowing yourself to be brought down by set backs are all important as well. Not easy when you are anxious.

I have heard generally good reports of Zoloft and as said earlier more bad reports seem to come from people who do not take it for long. I fully understand why they don't as it is often so hard in the early weeks or even months. In the case of Venlafaxine it seems to have people who either think it is terrible and stop early or people who find it a life saver. No antidepressant will be very effective without a supportive lifestyle.

You have done therapy workshops and hopefully that will support you.

Try not to worry, many people add another antidepressant if they need to rather than switch so that is an option if you do not find it effective enough in the long run and your doctor advises it.

Very best wishes, you have had some good periods and you are tapering off Ativan so it will not be easy, you are doing well and I am sure will overcome your anxiety whatever you decide to do in the long run.

Kim

[Mongea in reply to Kkimm]

I don not have any moments of euphoria. However, I do have good days that are filled with joy (where I almost forget that I’m being treated for anxiety). That’s what keeps me going. I’m hoping once I’m weaned off the Ativan and I stop increasing doses, I can get stabilized.

[Hidden]

You said decrease to your Ativan....that could easily explain the anxiousness. You're taking less of an anti-anxiety medication and your body is trying to adjust to working with less. If you're taking another medication (like a SSRI/SNRI) and the dose is increase, side effects can absolutely return. You're taking more of a medication and it's adding more to the mix. The same side effects you had initially may return (and they might not). Hang in there as you dose off of Ativan. That's a tough medicine to work off of and it sounds like they aren't being too harsh with it or your anxiety would be pretty bad. The side effects of withdrawal also play in here, so it can be a little rough, but hang in there...it sounds like everything is perfectly normal. Best of luck and remember to try some mental exercises (mindfulness or deep breathing) to relieve the stress/anxiety.

[Mongea in reply to Hidden]

I still have four weeks to go on the Ativan decrease! Feels like forever- and at the same time increasing the Zoloft. I’m having to dig deep with a positive attitutude.