# SSRIs for some of us: worsened apathy?



## theheadlesspostman (Oct 30, 2011)

I've suffered derealisation for a decade, and over the last year played around with different SSRIs at different doses.

I've just made it to about two weeks of Lexapro (escitalopram, cipralex in Europe) and things are much worse for me. I can't get out of bed. Want to sleep constantly. Isolating myself. Can't stand to speak to or socialise with anyone. I've been drinking and eating a lot everyday just to deal with the complete apathy and numbness. It's like I'm dead. Worse than derealisation in its unmedicated form and worse depression.

I realise medication is different for everyone, and that SSRIs work for many, but Lexapro at 10mg is intolerable for me. 5mg was, as you might expect, half as bad. I don't think I can take it any longer, unless there are people here who experienced things becoming MUCH worse for the first weeks, only for things to turn around entirely? I've not taken a dose for over 24 hours now and while still exhausted, the horrible lack of feelings is already lifting quite dramatically.

Is it worth sticking with, considering how horrific it's making me feel? Has anyone had this happen, only to recover and feel great a week later? Or is my response so intense it's unlikely to get better?

I understand any advice is anecdotal, so please don't feel uncomfortable to offer some. Decisions will be made with my doctor. Again, I know SSRIs do work for many, and this post *shouldn't stop people from trying them*. Derealisation has different causes for all of us and I've read people recovering entirely while taking them.

I'm just trying to get a sense of if others have had such a horrible experience, toughed it out and recovered, or whether in my case it's just too miserable to continue? I'm not sure I can stand another week or two of this.

Many thanks in advance to any kind people who might be able to offer their anecdotes.


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## Pondererer (May 18, 2016)

I've felt like i have gained some more numbness after starting meds, but i'm not sure. But, it's not a horrible one, it's more like a boring but practical one. I used to worry and be scared of killing myself, failing school et etc. These days i litterally don't care. If i were to die, that would only be nice and practical, right? Because as the DP tells us, nothing matters anyway, so it feels like there is nothing to be sad about, because, it's actually "nothing". I dunno kinda hard to explain.


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## MichaelTheAnhedonic (Aug 31, 2016)

SSRIs are known for lowering dopamine transmission and because of that - apathy and numbness occurs.

SNRIs such as venlafaxine are better in terms of reducing apathy.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2989833/


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## theheadlesspostman (Oct 30, 2011)

Pondererer said:


> I've felt like i have gained some more numbness after starting meds, but i'm not sure. But, it's not a horrible one, it's more like a boring but practical one. I used to worry and be scared of killing myself, failing school et etc. These days i litterally don't care. If i were to die, that would only be nice and practical, right? Because as the DP tells us, nothing matters anyway, so it feels like there is nothing to be sad about, because, it's actually "nothing". I dunno kinda hard to explain.


Not to belittle your situation I'm sure it's been really tough. But it sounds like my experience is more extreme. I could deal with the 'blahs' if it took away the derealisation. In fact, I deal with some apathy unmedicated already. Life is boring on a normal day, although I can feel excitement too. But on Lexapro It's an intense exhaustion and apathy that makes life worthless.

If others had had such a horrible experience, only for the sun to come out after a month and the drug to properly 'kick in' then I could try and keep going. But it seems SO bad (I'm in bed, drinking too much alcohol to deal with the pain of the apathy, my flat is a total dump because I can barely get out of bed to brush my teeth let alone clean up, I can't stand to talk to anyone so work is impossible...the list goes on) that I can't imagine how the situation will turn 180 in a week or two.

I'm feeling better and better as the day goes on since I haven't dosed in at least 24 hours. I'm just concerned that because I haven't given the drug a full month to six weeks as suggested I might really benefit from it if I keep going. But the effects so far are so appalling, and bearing in mind SSRIs are very hit and miss with this condition (some say they helped, others say they cured them, others that they made them worse) that I just can't go on unless there is at least some anecdotal reports of people going through hell in the first few weeks and then everything turned around for them dramatically.

My gut is telling that because I already experience apathy without drug that Lexapro, a medication known to blunt emotions further is the wrong way to go. But I'm so interested in more anecdotes before I go to my Doctor and make a decision.


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## HopingCat36 (Jun 17, 2017)

> I've suffered derealisation for a decade, and over the last year played around with different SSRIs at different doses.
> 
> I've just made it to about two weeks of Lexapro (escitalopram, cipralex in Europe) and things are much worse for me. I can't get out of bed. Want to sleep constantly. Isolating myself. Can't stand to speak to or socialise with anyone. I've been drinking and eating a lot everyday just to deal with the complete apathy and numbness. It's like I'm dead. Worse than derealisation in its unmedicated form and worse depression.
> 
> ...


Maybe you can request for a GENESIGHT test? It I will tell you what medication will work best for you and which to stay away from. I got it done after Zoloft wants working. And when the results came back Zoloft was in proceed with caution colum. Lexapro is in my stay away colum.


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## mar (May 26, 2017)

Im currently on Sertraline. I've been on it totally 13 weeks and therapeutic dose (50mg) for 9 weeks. I had a really hard time when I started taking them. Extreme dpdr. I had a lot of anxiety and was really depressed too, which is better now but the dpdr is not better. I would say it was better before the meds - It's still extreme.

If I could turn back time I would never pushed my self through the side effects, the result was not worth it. So I'm planning to decrease the dose slowly and hopefully my dpdr will get better, but at the same time I'm afraid I will get depressed again.

But I don't know, for some people maybe it's a huge difference after being on the meds for a couple of weeks.

The weirdest part of it is that sertraline helped me recover 7 years ago, but I'm having a totally different experience this time. But I know SSRI definitely can help a lot if you find the right one..


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## HopingCat36 (Jun 17, 2017)

mar said:


> Im currently on Sertraline. I've been on it totally 13 weeks and therapeutic dose (50mg) for 9 weeks. I had a really hard time when I started taking them. Extreme dpdr. I had a lot of anxiety and was really depressed too, which is better now but the dpdr is not better. I would say it was better before the meds - It's still extreme.
> 
> If I could turn back time I would never pushed my self through the side effects, the result was not worth it. So I'm planning to decrease the dose slowly and hopefully my dpdr will get better, but at the same time I'm afraid I will get depressed again.
> 
> ...


That's the tricky part... finding the right one. I think this is why people give up and say medicine doesn't work and go on with this hell for years. Zoloft didn't work for me neither. I was on it for just 6 weeks. Now I am thinking to try something else because I don't know how much longer I can stand this hell Dp/dr on top of me 24/7.


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## 106473 (Feb 7, 2017)

*T*etracyclic gets my vote. SSRI is at the bottom of my list. Maybe we should poll it? (just so we could get a good understanding?)


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## forestx5 (Aug 29, 2008)

I've taken Prozac, Paxil, Venlafaxine, Citalopram, for significant periods, and trials of other tricyclics and SSRI/SNRIs. I currently take Lexapro at 40mg per day. That is a fairly high dose. I have zero side effects which was not the case with the previous SSRI/SNRIs. I'll keep taking Lexapro, thank you.


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## theheadlesspostman (Oct 30, 2011)

Just to update on this: I returned to Lexapro, because on coming off medication the derealisation got worse and I realised it had been helping. It was the apathy, which had indeed been worsened by the medication, at first, that made it feel so dreadful an experience.

However, after three weeks back on Lexapro the apathy has gone and I feel much better. I guess I'm yet another example of an 'impatient patient' who didn't give the medication time to work before. Or perhaps I was simply scared. Not unusual for someone suffering such a difficult condition.

Without wishing to jinx anything, Lex is now lifting my mood, starting to clear the derealisation, getting rid of the fog and giving me the strength to start fighting to live a normal life again. I can now imagine getting back to work properly, back to the gym, back to socialising. It'll take some time but at least I feel much more able. I hope it continues.

I think perhaps, because a lot of us are already 'numb' the initial start up apathy is really hard to handle and it scares us off. I felt almost dead. It did feel almost unbearable. Doctors do not seem to warn of this, perhaps because they don't know a great deal about depersonalisation.

I will say I also take a little dexedrine. I was taking that during my initial trial, around the time I first made this topic, so even that kind of stimulant didn't stop the apathy. But it may be helping now that the Lexapro has settled in.

I'm only taking 5mg Lexapro at the moment. I've read a lot about it being overdosed, making side effects worse. Obviously I will increase if needed, but at the moment it's plenty.

I thought it important to follow up here. Because my situation, which was appalling when I began this topic, has turned around and I find people who start to improve are less likely to come back and update. They tend to forget about it, because they're out living a life.

In summary. Lexapro for me was horrible for two weeks. It has totally turned about for me now. It is worth trying. It isn't perfect but it does seem effective.


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## allison84 (May 4, 2016)

Luvox helped the ocd so much for me back in 2008 when i was messed up , one week on 300mg of luvox which is a huge dose but one week ocd was gone , it was a massive help at the time .
I went of luvox in 2009 because of bad side effects, i lowered the dose of course .
In December 2015 I started back on luvox at a much lower dose but it made the dp dr so much worse , i was in a complete fog and dream world i couldmt cope with it at all , so i just stopped talking them and the fog lifted heaps , so my experience with ssri is it made the dissociation worse for me so will not take them unless my ocd flares up to a point were im completly out of control and cognitive behavior therapy does not work.


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## allison84 (May 4, 2016)

Also I found valium and tamazapan made dr dp worse to , bad bad bad dr dp on those BUT massive help to control panic attacks that are out if control and last for hpurs on end and YES I would take them in future if im in a bad horrible spot again in my future.


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## mar (May 26, 2017)

Thanks for the update!


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## bintuae (Jan 17, 2017)

SSRIs/SNRIs worsen my dp dr even after the initial period. The higher the dose, the worse it gets. I'm on pristiq now. I feel dead inside. No emotions at all. don't care about anything.I have no choice but to take it.


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## theheadlesspostman (Oct 30, 2011)

Back again for another update.

Unfortunately Lexapro turned against me once more, and the apathy returned. I ended up stuck in bed again, not caring about friends, family, work, gym, generally looking after myself or life in general.

For me, Lexapro does indeed work a little, intermittently, in reducing derealisation. At the expense of becoming a lazy, useless, sexless robot. I've put some weight on, because I've not been able to force myself to eat well or care about exercise which I now have to undo, which I will. The knock to confidence isn't helpful on top of everything else. I noticed it also made me drink much more, because I was desperate to 'feel'. As we know DR/DP makes us feel numb. SSRIs on top, for some and certainly me exaggerates that numb feeling and I start seeking things to ease the trapped, dull sensation.

It works very well for some, but not me and therefore my trial with this drug is done.

Now on to Moclobemide with a small dose of diazepam.


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