How Do You Know If Your Antianxiety/antidepressant Isn't Working?

Updated on September 24, 2009
T.L. asks from San Pedro, CA
22 answers

Long story short, I have a 3.5 month old baby, and had some postpartum depression, and at 7 weeks postpartum had ear surgery that left me very ill and created constant panic attacks / anxiety 24/7. After hanging in for 5 weeks of that, I was hospitalized for 2 weeks at a psych hospital to stabilize. I won't go into how awful the whole thing was, I have 2 other kids besides the baby. And i had to wean the baby cold turkey when I went into the hospital, and now have slight menstrual bleeding about every other day.
I have now been on Lexapro for 3 weeks (10 mgs once per day) but I still feel very agitated / angry / anxious. Am also on a very small dose of Klonopin (.25 mg in morning, .25 mg at night, because .5 mg dosage made me too out of it mentally).
I see the psychiatrist on Wed., but am concerned that the Lexapro just isn't working and would appreciate hearing other's experiences with antianxiety/antidepressants. My main problem is anxiety / agitation with depression being secondary. I am very concerned because sometimes the agitation gets so bad I am afraid I will need to go back to the psych hospital again!
BTW, I also just started taking niacin and a B complex vitamin this morning twice per day which was prescribed for tinnitus from the ear surgery.
Did anyone else just not have the meds kick in for over 3 weeks at all? I know the full effect doesn't come for 4-6 weeks, but I'm afraid maybe the meds are making me worse, not better. Or was it just not the right med for you? How did you know??????

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So What Happened?

I have not even had the time or presence of mind to thank everyone for their wonderful advice / responses. I especially am grateful to those I don't even know who are praying for me!
I went to the psychiatrist on Monday who was assigned to me once I left the hospital. He seems decent so far, and much better than the hospital docs I hope. He immediately took me off the Lexapro since I'd only been on it for 3 weeks, and it was obviously not a good med for me. He was very surprised the hospital had tried to put me on that, since I'd had an initial bad reaction to Zoloft for 3 days prior to switching to Lexapro. And they are the same class of antidepressant so the doc couldn't understand why they would try me on such similar meds. We decided that considering my circumstances and the fact that the anxiety was mostly due to my body's reaction to the ear surgery, that I would try to go off all meds and see what happens. I had already weaned off the Klonopin, which I would have to do anyway since it's a short term anxiety solution and highly addictive.

Well, I can honestly say it's been one of the hardest weeks of my life. I had a cold virus to boot, and had major withdrawal the first two days from the Lexapro, very nauseated, felt just very strange and awful. But then that subsided. Now I am still continuing to have major panic attacks almost all day long, so we are trying Neurontin of all things. Long story short, a couple years ago, a doctor tried me on Neurontin for the vertigo problems I was having, thinking it could have been due to basilar migraines. So I know at least I don't have bad side effects from Neurontin (or at least I didn't then). So I just started today, it does seem to help the anxiety a little bit, but only time will tell. Supposedly Neurontin has worked very well for some people with anxiety who can't tolerate antidepressants. Especially since I really am not depressed, except about my circumstances of course.

BUT, I really want to know more about herbal and homeopathic treatments for the future, so will be reading those emails with a fine toothed comb. If you have any referrals for great homeopaths in Los Angeles (South Bay and Long Beach area, or anything along the 110 freeway is best/most convenient for me as I live in San Pedro) I would really appreciate it.
Also, I really really appreciate prayer. I believe more than anything this is a "spiritual battle" for those of you who understand that term, and I don't understand why the Lord still is allowing me to be at this horrible place. This is so frightening for me, I have always been a very even keeled person for the most part. I am really struggling with this as well as hostility / aggression / fear feelings during the attacks, which that terrifies me since I really don't know what that is all about!
Thank you for helping.

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R.G.

answers from Los Angeles on

hello tara,
i dont have any real advise, just wanted to let you know that i hope things will get better for you. my little brother just had an incident with anxiety and it was very scary for all of us. i do not have an experience myself with taking the meds you mentioned. i think you are very brave for posting this and trying to get help. good luck!

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J.D.

answers from Los Angeles on

Tell your psychiatrist what you told us. Three weeks on an antidepressant is really just a beginning. It took quite awhile for my meds to be adjusted properly. There are medications like Buspar that have more long-lasting impact on anxiety. Klonipin is useful, but more for when a panic attack is happening.

There are LOTS of adjustments that can be made in your medication. There are just tons of different medications and dosage levels that might help you. Just make sure you communicate very clearly with your psychiatrist. If the doctor isn't making adjustments to improve your condition, find another doctor. Like every other profession, some are better than others.

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K.L.

answers from Los Angeles on

I will share a little of my own experience I am not sure it will be helpful but perhaps hopeful.
after my second child i was given welbutrin to help with the depression and lack of motivation. It helped a ton but i noticed I would overreact to small things my anxiety was defiantly worse but i was getting out of bed in the morning. I was then given Prozac and that seemed to help. it defiantly made sleeping and eating easier. i went off both when getting pregnant with my 3rd baby. also during this time i was seeing a counselor and working with someone on my nutrition and supplements. after my 3rd baby i did not have the symptoms to the same degree as after the 2nd.

all these things were helpful but the main thing that got me through was prayer. I cant say prayer alone healed me but i can say i was able to know what route to take. I would pray to find the right doctors, I would pray to find the right meds, I would pray for help and hope. Prayer is what put me on the path to find the right combination of things I needed.

It sounds like you have a very faith based home and i am sure prayer is already your constant companion. I just wanted reaffirm that it works. I am so sorry you and your family are going through this right now. It is so hard to have a darling baby and a wonderful family and not be able to enjoy them. my heart and prayers are with you. i hope you will be able to be led to the right combo of things that will get you through.
You are not alone and you are a wonderful example of a brave strong mother we can all learn from.

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M.M.

answers from Los Angeles on

Hi Tara,
You are brave to be so forthcoming - good for you! I have to respond because someone else wrote that "progesterone is a depressant". This is absolutely NOT true! That Mom was on a synthetic form of Progesterone which technically is "progestIN". The human hormone ProgestERONE plays a HUGE part in moods, anxiety, postpartum.

I had ppd after the birth of both of my boys. My doctor immediately offered Prozac. I choose to try bio-identical Progesterone cream which contains hormones extracted from plants that are the exact chemical structure of the human hormone. Drug companies intentionally tweak the hormone because they cannot patent it if it occurs in nature, which progestone does. Bio-identical creams are available over the counter, from many sources because they can't be patented.

I have no idea if this will apply to you but you should check it on your own. Hormone imbalances lead to a long list of symptoms including depression, insomnia, anxiety, fibromyalgia, fibrocystic breast, etc. My doctor is now coming around & reading Dr. Lee's book (a pioneer in this field) although she initially brushed it off. A good place to start is www.drjohnlee.com

You are NOT a failure! You are a good Mom reaching out for the help you need. You will get through this. Hang in there.

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R.A.

answers from Los Angeles on

it can take quite a while for them to kick in...can be very frustrating...i have been off these types of meds for 6 years but had lots of experience with them...6 years ago I went to my church small group leaders and had them pray with me and believe with me that I wouldn't have to take these medications any longer if possible...they did and their gift of faith helped a lot along with the Lord healing my body....you have gone through a lot and with the ear surgery so soon after your delivery..seems like things just got out of balance....hang in there and since it came out of nowhere it seems that it will return to normal...just go under your doctor's care and in prayer and hang in there...some of the side effects of these meds are hard to deal with and make you depressed/anxious just dealing with them...saying a prayer right now that God will heal your body and you will have wisdom to know how to deal with all of this....

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K.

answers from Las Vegas on

Tara,

I went through something similar (almost hospitalized for it) and the anxiety was just awful. You feel like you're going to come right out of your skin. I was put on antidepressants and anti-anxiety medication. I also had cognitive therapy weekly for almost a year. It does take awhile for the meds to kick in, but your dr should be able to give you something for the anxiety that takes less than 6 weeks. Also, as others pointed out, not every medication works the same way for everybody so you may have to try several different combinations. Work with your doctor on this. Another thing that helped me was exercize. You won't feel like doing it (the meds make you tired), but even just walking will help burn off a some of the adrenalin and cortisol caused by the anxiety and take the edge off. It sounds like you've also got a lot of positive, supportive people around you, which is also extremely important--don't be afraid to ask them for help. Also, be prepared for this to take awhile to get through. Even with medication, it's a gradual improvement, not like just waking up one morning and you're all better.

It sounds like you've been through an awful lot. I know it's really hard now, but as someone who's been through it, I promise it does get better. Please feel free to email me, if you want.

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S.K.

answers from Los Angeles on

Hi
I'm so sorry you are going through this right now. I experienced the same thing (without it being post partum) and just know that it WILL GO AWAY. I also checked myself into a hospital from having approx. 10-15 panic attacks a day, insomnia, severe depression.
I wanted to tell you that I am on Luvoxamine and feel great on it. No adverse reactions like I had on others, such as weight gain, the shakes and sexual disfunction.
I also wanted to tell you about something called Cognitive Behavorial Therapy.
It changes the way you think and half of panic and anxiety is our thoughts. I used to have panic attacks because I was having panic attacks! I can't recommend it enough. I know if you GOOGLE Cognitive Behavorial therapist in your area you'll find some choices.
I feel I will always battle some sort of depression (as it runs in my family), which is why I'm on antidepressants. But I am free of any anti-anxiety meds because of this therapy.
It changed my life. I also used to be terrified of flying and because I know the tools to retrain my brain, am no longer afraid.
Best of Luck, there's an end in sight!

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A.T.

answers from Las Vegas on

I know this sounds weird, but my depression and anxiety didn't happen until after I stopped nursing my first child...so really it can happen anytime. My personal opinion is that it is a result of hormone imbalance in the body...not necessarily the Seritonin and all the other stuff that is in the antidepressants. I think it has a lot to do with progesterone and estrogen balance...etc. Doctor's won't help with this issue because it is a fine balance in the body and it is an area of medicine that is not well understood or studied. There is an awesome website that helped me "womentowomen.com". Their advice will help you to feel that you are not crazy. I also have started seeing an awesome chiropractor in the Las Vegas area who also does homeopathic medicine and has his liscense to do so. He has helped me with a lot of these issues and I have been off antidepressants altogether now after seeing him. I would try the antidepressants for another week or so and if you don't feel any change then U would seek other help. I like Dr. Todd Schleusner (the chiropractor I talked about before) because he is all about helping people feel well again without them having all the nasty side-effects of medication. I wish you the best.

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S.T.

answers from Los Angeles on

Dear Tara, Please allow me to congratulate you for your bravery and forthrightness in describing your illness on a public forum. There is so much mystery over mental illness, which is actually just one more kind of bioogical illness that, like many other illnesses, can be triggered by various events or environmental causes. If we could all discuss our challenges as openly as you have, we could do a lot better than we do now!

I don't have any specific advice for you in regard to a specific medication, but I can tell you that you may face a long haul of having to constantly tweak medications to get good results. Something may be working perfectly and then it doesn't any more. It's very frustrating, and often leads, unfortunately, to going off the meds. Disaster then can follow!

You might also like to google "cognitive therapy." There is a lot of evidence that this type of therapy, sometimes in conjunction with medication, and sometimes by itself, depending on the condition, can be the best answer. Although it does involve seeing a trained therapist, it is not what we think of as "talk therapy." It doesn't involve delving into your past, or "understanding" yourself. I believe UCLA might have some good leads for you. I know the Mayo Clinic has some programs. The University of Washington in Seattle has been a pioneer. My sister in law went there, (I think she had a lot of your issues) and her therapy, in conjunction with some initial medication, led to a life-long positive change. She went on to become a counselor herself and became a children's court advocate.

I note that some people suggest nutrition as the answer. Although certainly a health diet is good for us all, and does impact our total health, I believe you need to beware of too much trust in diet alone. I have a lot of experience with mental health issues through family, and I can tell you that at least two members are obsessive about diet and supplements, but it has not impacted their mental health. It has almost fed into their anxiety and obsessive issues! Please do look into cognitive therapy. It is not a fad. When Mayo Clinic offers something, you can be sure it is mainstream!

S. Toji

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E.B.

answers from San Luis Obispo on

Tara,
Give your meds sometime. If they are working, you won't really be aware of how effective they are, but those around you will. With all you have been through, give your body a chance to settle down. If you have support at your church, ask them to keep you on a prayer list. Often times they can assign one person to pray for you while you are going through this transition. When your hormones settle down, your ear problem subsides, and those post partem blues leave you, you will have a better outlook on things as your medication takes hold. I know you know this, but try to lean into the Lord and let His peace overwhelm you. It won't be constant, but it will help. It sounds like your being aware of what is going on, is a very good thing. You are a good mother, you are a woman with a body that has had some traumatic things occur and it will settle down in time with everything you are trying. I will lift you up in prayer also.

One of many who care about your well being.

E.:)

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S.P.

answers from Los Angeles on

i am so sorry you are not feeling well. i know exactly what that's like because 5 weeks after my son was born, i had a total postpartum psychotic breakdown. it was so bad i had to move in with my parents and be put on a constant watch and couldn't be alone with my child for at least a month!

my psychiatrist also put me on lexapro and klonopin and same thing, after 4, then 5 weeks it wasn't working and i wasn't feeling better. i made the mistake of upping the dose of klonopin which still didn't work. my dr. put me on abilify. it is a drug that is used mainly for schizophrenics but in small doses is combined with antidepressants. literally after about 4 or 5 days, i started feeling sooooo much better and within a couple weeks i was almost back to myself.

the only really big problem at that point was weaning myself off the klonopin. altho it was a low dose, i didn't sleep for 7 days and i was more agitated, nervous, than i had been before. my Dr. told me to hang in there and then on the 8th day i actually slept a whole night and started to feel better.

i was on the lexapro/abilify combo for a year and got off it with no problems. it was strangely the best and worst year of my life and i am just thankful it's over. definitely ask your Dr. about abilify. it works!!!

good luck!

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S.W.

answers from San Diego on

Hi Tara,
I also had Post-Partum Depression/Anxiety/Panic Attacks. It was awful. My OB put me back on the birth control pill and also prescribed Paxil for me (5mg) a day. I also participated in therapy over the phone 2x per week. It took a little while but I was feeling better every day. Hang in there and work with your doctor. Hopefully you will be feeling better soon :)

S.I.

answers from San Diego on

Dear Tara, This is all due to a hormonal imbalance, which no antidepressant can fix! Please contact a local classical homeopath or acupuncturist who specializes in women's health and knows how to work with herbs. One of these two approaches will get you back in balance--and off the antidepressant--in no time.

Let me know if you need a referral...I have contacts and can find someone in your area who can help.

Blessings,

S. I., L.Ac., HMA
Lotus Wellspring Healthcare
456 E. Mission Road, Suite 100
San Marcos, CA 92069
###-###-####
____@____.com
www.lotuswellspring.com

K.A.

answers from San Diego on

This is going to sound like a totally unrelated question but I'll explain why I'm asking in a sec...are you taking the mini pill as birth control after your baby was born? At 6 wks my OB put me on the mini pill because I was breastfeeding and wanted BC. The mini pill is progesterone only. I fell into severe postpartum depression. I was given Zoloft. It sat in a bottle for a while and I stared at it. I just couldn't make myself take it. I had a nurse friend ask me about the BC pills, she said progesterone is a depresant. I finally ended up stopping the BC pills and it wasn't very long after that I started feeling better with a full return to "normal" not that long after. I never took the Zoloft in the end. When I had gone in to see my OB I had mentioned what my nurse friend had said about the mini pills and asked if maybe that was the cause, she really brushed it off and was a hard sell on the Zoloft instead. I never felt comfortable with the idea of taking them, not wanting to become dependant and not wanting to cause any harm to my baby through the breast milk as well as the fact that we could be playing for months with the dose etc to
"get it right", when in fact what was causing my problems was birth control pills. Obviously I do not know if this had anything to do with you but I thought I would throw it out there just in case.
Best of luck!

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R.J.

answers from San Diego on

If you're asking the question, it's probably a sign it's not working. It could be the wrong drug, the wrong combo, or the wrong dose.

ALWAYS feel free to call your doc, to discuss meds. Med management really needs to be an open dialogue. What works for one brain won't work for another at ALL, or only works if you add "x" to it, but then you find you need less of "y", but with less of "y" you need to also add "z", etc.

Also, there is almost never a wonder drug. Most of the people I know on meds for anxiety/bipolar/etc...actually take several. One works as a mood stabilizer, another works for the anxiety, another works for etc etc etc. Before there was nyquil, people used to take about 8 pills on average to get the same effect...and then nyquill came out with a syrup that had all 8 alerady there in one dose. You DON'T want to do that with psychiatric drugs (for soooo many reasons), so what happens instead is that your medicines get custom tailored to suit YOU and your brain chemistry. You end up with a handful of pills...but it's just like nyquil. You only get the effect you're looking for when you add them all together.

My SIL and my best friend are both bipolar. (And then PTSD is an old friend of mine). Lexapro & Lamictl works for my best friend, but it took her a year of tweaking those two (and several others) before they found the "right" combo...and she periodically has to raise or lower the dose depending on what's going on in her life. Depakote USED to work for my SIL, but then she started having mixed episodes. So they upped the depakote, and she got reeeeallly bad. Pulled her off of the depakote stomped her with some heavy drugs to get her through a bad stretch, started backing off on them, replaced some with others, found a bad reaction in Trazidone, subbed that with something else...etc. But here's the kicker...even with all the tweaking, ALL of the depakote replacements were better than the depakote, which had worked flawlessly for years. Her brain chemistry changed after her pregnancy with her SECOND child (but not her first), so that it didn't react well with the depakote.

With both my SIL and BF, they were on the phone almost daily with their docs to touch base, and a weekly appt. for the first several months. Once they had a pretty good combo worked out, the phone calls and appts started having more space between them, until now...they only call if something starts to feel off.

So yeah...it's completely common and expected for people to have different reactions to the same drug, and for your own doseage needs to change as well.

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J.P.

answers from Los Angeles on

OMG, it's your hormones....regardless of the blod test results. If you are bleeding that much, then it's hormone related.

I've known a lot of moms to take adrenal support and it helps tremendously....also the right kind of calcium to relax the nervous system at night make a huge difference in the quality of sleep, which allows us to handle stressors differently. Adreal in the am and calcium at night.

This Adrenal Complex helps to balance out the hormones.
www.worldlifesupplements.com (the calcium can be found there too!) My doctor gives this to me and my moods are FAR more stable. If I had gone to any other doc, they would have diagnosed me as bipolar, or something crazy like that. With this supplement, I feel so balanced and it's causing my body to get healthier rather than rely on the drugs.

My husband, who is really even keel, even started taking it and I noticed that he gets less aggitated at the kids and has more patience for me.

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M.G.

answers from Las Vegas on

I didn't see any affect with Lexapro. I was on it for 3 weeks, and nothing. I switched to Zolft after that. Zolft for me, started working after 5 days or so. I hate being dependent on drugs, but riught now I need it. BTW, don't feel like you have to justify your reason for needing drugs right now to ANYBODY.

BTW zolft makes me SUPER tired...so I take it at night. I take 1 50mg pill a day.

Good luck with everything!!!!!!!!

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M.M.

answers from Los Angeles on

Hi Tara, sorry to hear you are going through all this. It is true that it takes over a month for the meds to starting kicking in, but if your not seeing any help from them, then maybe you should see about changing them. I had to due that a couple of times to find the right meds. I lost my husband to suicide and was so depressed trying to deal with that and suddendly being a single parent to a 9 and 7 yr olds. I finally found Depakote worked for me. They say for anxiety Cymbalta is good. I wish you luck and hang in there things will work out soon.

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L.H.

answers from Los Angeles on

Dear Tara,
I am so sorry that you are going through such a dark time just after giving birth to your 3rd child. I know you did not ask about breastfeeding but I do believe that this might help you get through this. Of course, the meds and your diet would need to be looked at and monitored closely. I am a lactation consultant and registered dietitian who might be able to help. I offer lactation consultations in the privacy of your own home via SKYPE. Please visit my website at: VirtualBreastfeedingHelp.com to make an appointment. I do hope to hear from you, Tara. Please take care,

L., RD, IBCLC

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K.C.

answers from Los Angeles on

Hello Mama love, to be honest the prescriptions are no good. Please take a look at EFT. http://www.emofree.com
Not only have I been able to help people with emotions and depression using the technique, even allergies and physcial pain.
I gave you the link to the EFT website, not my own. It will seem strange to some people (the technique) please give it a try. So many people, even if they were skeptical got off meds from this. More psychiatrists and psychologists are being turned onto this now. If you have any questions at all, I'm happy to speak to you on the phone. ###-###-####
Many blessings to you.
K.

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M.H.

answers from Los Angeles on

hello tara,
you might try increasing your Lexapro to 20mg a day. I was on 10 and felt it wasn't enough. the 20 works well for me. That is usually the limit although I have heard of people taking up to 40. however, mine is more for depression. A friend of mine benefitted greatly from Lexapro (at 20 mg.) for mostly anxiety problems. it is worth a shot. Also, there is always something to be said for relaxing body/mind therapeis such as restorative yoga classes, acupuncture, massages and so on. They make the final difference for me. Lastly, talk therapy to 'air out' all the mental worries and concerns about your life being consumed by being a mother, can also help to releae that anxious energy so it doesn't overwhelm you. best of luck

good luck.

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J.W.

answers from Los Angeles on

Hi Tara. I hope things are better for you. I was diagnosed 6 years ago with anxiety. It took almost 4 months for them to diagnose me - and another 4 months to get the dosage right on the medication. (I was on Paxil). After a year on, they weaned me off. Was good for about a year - and with a death in the family, the anxiety came back with such force. So here's what I learned:
Society's Poor Solution is dozens of synthethic drugs to mask the tired-stressed-depressed syndrom. Antidepressants, anti-anxiety drugs, coffees, caffeine pills and sleeping pills abound. Even so-called 'energy' drinks are a burgeoning market. All 3 of these product classes together represent tens of billions in yearly sales attempting to treat the tired-stressed-depressed syndrome!

Dr. Shawn Talbot has spent the better part of the last 10 years researching 'hormone balance'. (and we all know how out of whack our hormones become after having a baby!) He has created Eleviv for Xango. I love this product. I started taking it 2 months ago. I was able to reduce my Paxil dosage in half one month - to halving again the next month, and this month, I'm happy to say, I'm off PAXIL completely. And I feel more cheerful, resilient, peaceful, energetic, vigorous, alert and youthful!

So, if you (or anyone else) are stressed, get less than 8 hours sleep a night, or constantly feel fatigued during the day, or often feel 'blah' or downright depressed - let me know. I can direct you to my webpage or meet with you to discuss this product in more detail.

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