Antidepressant Causing Anxiety?

[Anxoid]

Hello folks, 43yo, male, long term anxiety/depression sufferer here, having yet another bad episode. In the last month or so, I have been waking up with panic attacks, followed by terrible anxiety, all day. Medication helps a lot during these episodes.
I've been on an ssri for around 20 years, and for a long time i was doing reasonably well on the lowest dose.
My g.p. upped the dose, about a month ago, which hasn't helped at all yet. Perhaps it's even making things worse!
Does anyone know if its possible that a higher ssri dose could actually make anxiety worse?
I feel like i should go back to my old dose, but it will be some time before I can see my g.p. again.
Cheers all.

[ArthurB]

Definitely go back to your GP. There are many different meds they can try if the one you are on doesn't work as effectively anymore.

[Anxoid]

For sure i need to get to the doc. I got an appointment, but that's a couple of weeks away. Not really sure if i should go back to my old dose, in the meantime...

[Innocuous]

Hi Anxoid,

Medications can definitely alter stress/anxiety levels. I usually have a reasonable level of anxiety, but while I was on SSRIs I couldn't feel stress about anything. Major assessment deadlines, rental payments, dangerous situations.... Nothing was making me stress at all to the point where I was letting important things slide.

I agree with Arthur that seeing the doctor is the best option. I don't think anyone can really recommend that you change doses against your doctor's orders. Could you visit a walk in clinic to get advice on a temporary dose change in the meantime?

It could also be worth doubling down on non-medical techniques like mindfulness and CBT to deal with your symptoms. I remember when I was on my medication I let a lot of these medications slide because 'everything was good' and I didn't need them.

Good luck with finding something that helps!

I

[Anxoid]

Heh, yeah. Nobody here really should advise against doctors orders. Bad idea.

Not sure if we have any walk in clinics around here, but mabey i should have a talk to the local pharmacist, their pretty good there.

[Anxoid]

And, yes, I've got to keep up with the mindfulness. Slow breathing helps too

[Want_to_be_well]

hi. in my experience, an SSRI dose increase can contribute to anxiety. Some SSRIs are more anxiety provoking than others. Making things even more complex, there's a thing called SSRI tachyphylaxis (or, as us mere mortals call it "SSRI poop out."). If you've been taking a particular SSRI for a long time, this may be happening, and an SSRI switch might be in order. Transition from one SSRI can make people edgy, but this usually lasts "only" a couple weeks. Hope this helps. Unfortunately I don't know which boat you're in. But it's worth mentioning both to your GP.

[Anxoid]

Cheers, yup I've been back to the doc, and we've lowered the dose, with a mind to change SSRIs, or perhaps a SNRI.

So hopefully something good will come of that.

[Innocuous]

Glad to hear you've talked through some options. I hope changing the dose has helped you feel better!

[Anxoid]

thanks everybody.

Well, I've gone on to an ssri now, after a pretty short tapering down period of a week or so. I'm 5 days into the ssri, and I seem to be only getting more anxious and depressed. I have basically no interest in anything now, and it's really scaring me. I can't seem to find any distraction from all my devastating thoughts at all.

I guess I'd better get back to my g.p. asap, which is difficult to organise for me as i cant sleep till about 4:00am, so i miss most of the day. Social phobia, and panic attacks on waking doesn't help either.

My g.p. has sent a referral to a psychiatrist at a local clinic, but I haven't heard back yet, and even if i get an appointment, it won't be for months.

This particular psychiatrist seems to be the quickest to get in to see, but the vast majority of reviews of him i see are absolutely terrible!

Here are some quotes:
"I'm still scarred from the cruelty and dismissiveness that this man emits".
"Absolutely dangerous!".
"He is at times, disrespectful, hurtful, argumentative and arrogant".
"Horrible excuse of a human being".
"One of the worst psychiatrists Ive ever seen over25 years".
"Very disrespectful. I have no idea why he works in this field where he can damage vulnerable people". "
"Remote and inscrutable; certainly knowledgeable but his manner is off-putting as it smacks of indifference and superiority even if this is not his intention".
"This so called doctor got paid a fortune to write a 2 page report on me, telling my GP he would be happy to see me again whilst telling me he did not want to see me again as he did not like me?"
"Escaped from Melbourne after he devastated a family when his failed methods contributed to the death of a patient."

There are also a few people with some good reviews, but the vast majority are like the above. It might just be one person making all these comments though, who knows? It's easy to make several accounts.

I dont know who to believe, but I have, in the past had an absolutely awful psychiatrist who I would never recommend. That guy has terrible reviews as well.

Seems, the good psychiatrists here in Hobart have too many people to handle, my first choices are either not taking on patients, or have extraordinary long waiting times.

Well, that turned into a much ramble than i was going to make! I think I'm just venting now.

Anxoid.