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I am a 57 year old female. I took Imipramine - 75 mg - for…

I am a 57...

I am a 57 year old female. I took Imipramine - 75 mg - for anxiety for about 28 years. Then, after I was ill with a virus, my PCP switched me to Escitalopram - starting dosage 5 mg going up to as much as 20 mg. I am now at 15 mg but have developed severe TMJ, muscle and joint pain, daily headaches, drowsiness and overall blah feeling. I know that I cannot go off of this med altogether, however, would weaning myself down to 10 mg help me with this side effects? Please help with any advise. My PCP doesn't understand the issues that I am having and it is impossible to get an appointment with a psychiatrist or psychologist to even get my questions answered. Thank you.

Doctor's Assistant: How long have you been dealing with this? Is there anything in particular that seems to make the symptoms better or worse?

The symptoms have progressively gotten worse over the past year. I believe having my daily cup or two of coffee doesn't help, but I think that the meds - being on for so long and switching - has put me where I am now. I also know that more exercise would help.

Doctor's Assistant: Anything else in your medical history you think the doctor should know?

I am also on 50 mg Metoprolol daily. I am sensitive to meds. I am 5'4" and about 113#. I tend to be a worry wart but I have not experienced more anxiety with the Escitalopram - only with the increases in dosage until I became settled.

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Answered in 6 days by:
3/19/2018
Dr. Sabina
Dr. Sabina, Doctor
Category: Medical
Satisfied Customers: 7
Experience: Board Certified Internist
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Hello Jill and welcome! I'm Dr. Sabina and I look forward to helping you with your question today. I'll be back in just a moment with my reply.

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I'm sorry to hear that you are experiencing these symptoms. If you did not have these symptoms with imipramine and they became more severe with increasing the escitalopram dosage, it is possible that your symptoms are related to the the escitalopram.

Escitalopram can cause headaches, drowsiness, lethargy or fatigue as a side effect and less commonly neck/shoulder/back pain. These seem to be like your symptoms (except the TMJ of course).

I think it is reassuring that you describe not having experienced anxiety on the escitalopram, since you have had anxiety for many years I am sure that you would know yourself best when the medication is not effective for you. So the fact that the medication seems to be working but also is causing side effects is a good reason, I agree, to see if it safe to reduce the dose a little bit and hopefully reduce the side effects but also keep the anti-anxiety effects.

Depending on how long you have been on this dose (how long it took you to go from 5mg up to 15mg), I think it would be reasonable to try to back down to 10mg and see if your side effects improve. You can monitor and see if your anxiety is worsened on this dose as well.
If at all possible, it would be the best case if you could let your PCP know that you are going to try this, maybe they take email or phone messages? That way you could try to schedule a visit or maybe even a phone visit with them in 1 month to see how you feel on the lower dose.

I hope this was helpful for you. Please remember that JustAnswer is for educational information only and is not medical advice. Please let me know if you still have questions that I can help you with. I hope you are able to feel better soon, Jill.

Dr. Sabina
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Category: Medical
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