I was on citalopram from 2017 - April 2024 for GAD. I had to up it in 2020 briefly but was mostly on 20mgs.
In April 2024, I had the worst flare up of severe anxiety/panic i have ever known and my doctor basically said she thinks citalopram just isn’t working for me anymore and did a direct switch to sertraline (no tapering period), literally just straight to it because she said they’re both SSRIs so it is fine - boy did this make me unwell - i have since seen a therapist who thinks it wasn’t so much sertraline that was the problem but quite severe withdrawal from citalopram (i mean i was on it for 7 years!). 6-7 weeks on sertraline and i was just awful, my heart rate would not come down despite the breathing techniques, very very little sleep, just awful.
I see the doctor again who said that her priority was me getting some rest/sleep and so we agreed to go on mirtazapine. I have been dubious of mirtazapine because of the insatiable hunger, the grogginess etc. i started on 3.25mgs, went up to 7.5mgs and i am supposed to take 15 ( but i have only done so once). Even on 7.5mgs, yes i was sleeping which was welcome, but the hunger was constant, even after eating a big meal and pudding. I also feel so irritable and tired all the time. I have been taking only 3.25mgs again because i just don’t know if i can take the hunger. I don’t want to feel hungry and tired/irritable all the time - that isn’t living either!!
Now I am wondering if i should go on escitalopram but scared of insomnia, feeling worse before better etc. is there even any point if it’s similar to citalopram? I just don’t know what to do anymore. Any advice would be so so so appreciated. Thank you in advance.