Dual diagnosis & medication.

I had another appointment with my psychiatrist today, who told me that she believed that I have both AvPD and SAD.

Because of the SAD, she has prescribed Cipralex (escitalopram).

Does anyone on here have experience with Cipralex for AvPD or anxiety?

I've never been on SSRIs before. I'm kind of worried about the associated side effects with this class of drug -- namely, the suicidal ideation (I already experience this every day, and am worried about it worsening), weight gain (I'm a good weight, but have some prodromal eating disorder issues), and inability to concentrate.

Any thoughts/experiences with this class of drug?

Thank you.

I was on it and it made me very paranoid. Everyone reacts differently. Currently I'm on prozac - cliche, but it's doing the trick.

It does take a few days for the meds to kick in, but if they're not for you, if you feel worse, you'll know sooner than that. Don't wait if you're feeling worse - call the doc and stop taking them.

Good luck to you.

Feeling worse before you feel better on SSRIs, for *MOST* people, generally refers to physical symptoms rather than sudden suicidal impulses. The suicide/loss of impulse control side effect is more dramatic, but it's also more rare. The worst things about starting up an SSRI for me, at least, are extreme dry mouth and "ambush nausea" that comes out of nowhere, crashes over me like a wave, and recedes as suddenly as it came on. When the side effects are bad like that I tend to decrease my dose and then up it more slowly. (This is Paxil, by the way)

Of course I'm only taking a fraction of what's considered a standard dose, mostly because of my terror of long-term weight gain. Just about all the SSRIs cause weight gain within 6 months. Paxil is generally considered the worst weight offender, but for my body (and my sister's too, weirdly enough) it's the med that causes the least poundage. Several years ago the doctor put me on Lexapro (don't have the generic name in front of me), and after a few months I was absolutely revolted at the amount of weight I gained, in spite of increasing my exercise and reducing my food intake. The pounds packed on anyway. After switching back to my baby dose of Paxil, it took nearly 2 years to shed that excess weight. Ugh, never again!!!

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I think I may have both AvPD and SAD. Of course I'm terribly paranoid (well I'm paranoid in general) about taking anti-anxiety medication. Because there's always the possibility of weight gain and erectile dysfunction side effects. I've been using CBT exercises and I've noticed significant improvement with that. Since the depression has went away (though it pops back up for brief periods) and the social anxiety and paranoia lessened, I've lost weight (I'd say I look handsome now) and I've had a lot more morning wood and increased sex drive (as an avoidant male, that means I play with myself more). Considering that losing weight has improved my self-esteem (and my long-term health) and erectile dysfunction would lower my self-esteem (make me feel less like a man), I'm not going to risk it with meds.

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I strongly oppose taking medical drugs, and will never go down that path myself, but I completely understand those who do. Obviously I don't have the answer, but I believe there are a lot of alternatives to drugs. I know the things I've done have been helpful. My main problem is consistency and giving up too early.

Update:

Got prescribed clonazepam for anxiety attacks surrounding school requirements and having to engage in social interactions.

I was shocked. It really took the edge off. The anxiety and self-loathing was by no means gone, but I could deal with it without resorting to suicidal ideation to get through the hours.

I don't notice any impact on my avoidance, but the anxiety relating to interpersonal conversations that I get forced into aren't as excruciating.

That's fantastic news! And it works better over time. The meds won't alter your personality or your choice of defense mechanisms, but by cutting down on your anxiety, you can try to tackle the parts of your AvPD that are really making negative impacts on your life and start to make small changes that lessen those impacts.