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Dr. Z
Dr. Z, Psychologist
Category: Mental Health
Satisfied Customers: 5999
Experience:  Psy.D. in Clinical Forensic Psychology with a background in treating severe mental illnesses.
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I have anxiety and my doctor put me on Viibryd, which seemed

Resolved Question:

I have anxiety and my doctor put me on Viibryd, which seemed to make it worse. I went to a psychiatrist and he placed me on Remeron 15 mg and titrated up to 30 mg before bed. It seemed to be working but I was so tired during the day I could not function at work, so I tapered off (i was on it for a month) but anxiety came back and my regular doctor put me on celexa 10 mg to start after dinner. that night I had horrible anxiety and the feeling of being hot. I went down to 5 mg in morning but anxiety is still there all day long. Should I go back to Remeron or give Celexa a chance? thanks!
Submitted: 1 year ago.
Category: Mental Health
Expert:  Dr. Z replied 1 year ago.

DoctorZ :

Hello I believe I can help you with your concern

DoctorZ :

I am sorry that you are experiencing these anxiety attacks, I can imagine how distressing this is for you

DoctorZ :

Yes there Remeron does have a significant sedation effect and that can cause day time tiredness.

DoctorZ :

I will say this about the Celexa, the effective therapeutic dosage is at 20-40mg for most adults and it takes around 2-4 weeks to see initial benefits, and around 7-9 weeks to see the maximum benefits of this medication

Customer:

does the daytime tireness of remeron eventually go away

DoctorZ :

So while you are at 10mg and it has not been that long on the medication, this is probably why you are still have anxiety issues.

Customer:

do I need to talk with my doctor and ask if I should increase the dosage?

DoctorZ :

Usually with the Remeron after 6-8 weeks, your body should have adapted to the Remeron for it not to cause that day time tiredness, but it can be long lasting in some individuals

DoctorZ :

You should start at 10mg then after a week or two increase to 20mg and then increase it accordingly, but not higher than 40mg as this has shown no benefit to be higher

DoctorZ :

Also I will tell you that Lexapro, chemically very similar to Celexa, is more fast acting and more effective than the Celexa for anxiety issues.

Customer:

I guess I should ask my doctor about lexapro. Can it be switched over from celexa?

DoctorZ :

If you would like to continue with the Celexa, you can also take a low dose benzodiazepine (e.g. Ativan, Xanax, or Klonopin) temporarily until you achieve the maximum benefit of the Celexa. Benzodiazepines are very effective anti-anxiety medications, but can cause sedation as well, although that can be minimized with a low dose

DoctorZ :

Yes it can be switched with no problems, you should not have to wean off the Celexa at all.

Customer:

OK, thank you so much for your help.

DoctorZ :

I am happy to help. Is there anything else I can help you with today?

Customer:

I guess I would just have to persevere with the anxiety until meds take effect.

DoctorZ :

The benzodiazepine that I recommended is fast acting, usually taking effect within an hour or two, and that is why I recommended it temporarily until the Celexa takes full effect in your body.

Customer:

Thank you. I do have Ativan 0.5 mg but doesnt work sometimes.

DoctorZ :

I am sorry, you can switch to Klonopin and take a similar dosage or 1mg of it at night and it will last in your body for a longer time, so the sedative effects will not bother you during the day.

Customer:

Thank you so much. YOu have given me good information that I can discuss with my doctor. Have a nice day!

DoctorZ :

You have a good day as well. My goal is to provide you with excellent service, so if you ever have any further questions or concerns please do not hesitate to contact me at anytime.


 

Dr. Z, Psychologist
Category: Mental Health
Satisfied Customers: 5999
Experience: Psy.D. in Clinical Forensic Psychology with a background in treating severe mental illnesses.
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Dr. Z
Dr. Z
Psychologist
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Psy.D. in Clinical Forensic Psychology with a background in treating severe mental illnesses.