My journey with medication and anxiety began shortly after the panic attacks started to explode. I decided to give medication a go because the experience I had with counselling was not working quickly enough for me to be successful in school and I didn’t want to waste too much of my semester. I am not a medical professional, so my next advice is purely anecdotal, but it helps to have some firsthand knowledge when you decide to try medication. Medication isn’t for everyone, but I learned that it was helpful to try.
I have tried citalopram (Celexa), escitalopram (Cipralex), paroxetine (Paxil), fluoxetine (Prozac), and now desvenlafaxine (Pristiq). All but Pristiq are considered SSRIs and are also used for things other than depression, such as anxiety. Pristiq is classified as an SNRI, which acts on both serotonin and norepinephrine, instead of just serotonin like the SSRIs, essentially to achieve the same outcome.
The experience one has with each drug will be largely different in most cases. For Celexa, I had crazy bad headaches and was not on it very long. For Cipralex, I didn’t have any bad side effects, but it didn’t really do too much and I was on it for a few months. Paxil was the best fighter against anxiety for me, but it did its job a little too well and the term zombie was an understatement. I didn’t have emotions on Paxil and I slept a lot, but I don’t really remember having a panic attack. Paxil was also the hardest to taper off of and felt like the worst hangover I’ve ever been on. I was prescribed Prozac to help me taper off of Paxil and it was very similar to Cipralex – good, but nothing really changed. I’ve been on Pristiq for the longest time now (since May of last year) and I’ve had a love-hate relationship with it. As an SNRI, it seems to take my anxiety and make the baseline higher, but the intensities much, much less. My panic attacks don’t feel to be as world-ending, but I feel more anxious all the time than I have on other medications.
With that quick little update on my background with medication over the last two+ years… here are some things I’ve learned about medications and how they affected me:
1. It takes a few weeks to kick in and to get off of it.
The choice to start medication isn’t a sudden fix. It takes a while to find the right one and on top of that, it takes a few weeks for your brain to be able to let the medication do its thing. I really had to convince myself to be a good sport about giving the medication the chance to work for real, but it wasn’t always fun. For the first two weeks, I often felt icky. It was slightly nauseous, slightly headachey, slightly hit-by-a-truck-when-is-my-cold-starting kind of feeling. However, that did go away as my body got used to it. When I would switch a medication, especially with Paxil, it was also really important to taper under my psychiatrist’s direction. I learned the hard way one week that quitting cold turkey because “f this shit” is a really, absolutely, truly horrible idea. Red light, don’t do it, listen to your medical professional.
2. There are definitely side effects.
The side effects I experienced weren’t scary or bad, but annoying. After a few weeks on Celexa, with horrible, horrible headaches, I was swapped off it pretty quickly. That was really the only one that hurt. I would say, for me, Paxil and Pristiq have the most recognizable side effects, but I definitely gained weight a lot easier on all of the ones that I have tried. Paxil made me sleep all the time and I really lost my bucket of f*cks to give. Most of them had sexual side effects that came with them, but Pristiq really made me lose that bucket for good. Across the board, I’d often feel dizzy on bad days, which I self-medicated with caffeine, in the form of unhealthy energy drinks (NOT a good idea – caused pretty much a guaranteed panic attack). I did notice an increase for intrusive thoughts about self-harm, but I’m not completely sure if that came with the medication or the frustration with nothing working like I expected it to.
3. It changed my anxiety and how I experience it.
Overall, there have been a few noticeable changes in the way I experienced anxiety. Sometimes that meant that I coma’d my way through life, which was cool because no more anxiety, but really not because I didn’t accomplish anything. Other times, as in the case with Pristiq – I feel anxious all the time, but my panic attacks changed and I am able to pull myself out of them much more quickly and they don’t last as long. It really is a balancing act with medication and I think that’s why working with Cognitive Behavioural Therapy and positive self-care really helps through the whole process of feeling better.
The things that I really feel affect your relationship with anxiety, medication, and feeling better are also included in what is going on in your life currently. At the end of September this year, I lost my best friend from junior high and I haven’t really felt okay since. I noticed that shortly after that emotional blow, my relationship with Pristiq drastically changed. I am caught in an abnormal sleep schedule that I can’t fix no matter what I do, and that lovely change with my panic attacks seems to have lost its touch a good amount. In a situation like this, all I can hope to do is make another appointment with my awesome psychiatrist and see what he thinks. He is an excellent resource and always includes me in decisions about my mental health and the direction I want to go next. At the end of the day, I think that is the most important point: I have the choice to continue or to try a clean slate. At the end of the day, you do as well. I can only hope that my experience with medication relieves a bit of hesitation or anxiety you may be feeling towards it. When I was first making the decision to try medication, I utilized personal accounts on r/Anxiety to help me understand what was going on as well as questions to my pharmacist and health link line. Good luck, friend, you’re not alone.