[Guest]

Dr.,

I am now into my 9th week at 40mg of Celexa, and doing considerably better than I was at previous doses (more stable, not so many swings in anxiety from day to day) and therapist says my HAM-A scores are staying at 6-7. I am wondering about length of treatment and recovery.

Once before you had told me at about 8 weeks "what you see is what you get". I have kept this in mind when assessing my own feelings of my progress. I still have some symptoms remaining (worry about achieving full and lasting recovery, nervous tension, muscle tension)and they are generally mild, but enough to be bothersome. The physical symptoms (particularly panic) are gone with the exception of the muscle tension. I have asked both my Dr. and therapist if we need to be more aggressive in targeting the remaining symptoms.

Both seem to think that at this point, time is what I need, time to get used to the improvement, and time to consolidate the improvement into a full remission, no additional interventions. This seems to contradict what you had mentioned in the past, and I want to be sure that it will not be lost time waiting for full recovery. Can further improvements occur beyond the eight week period which will lead to more complete and sustained resolution, and is this a common approach?

Also, what is the current standard on length of treatment once full symptom resolution (or close to it) has been achieved?

Thanks as always.

[Guest]

These questions are more judgement calls than subject to hard and fast rules. It is possible that if you were to augment with an agent such as Buspar there might be additional improvement. On the other hand, you are adding another agent with potential side effects, so it becomes a judgment call. Similarly, many people say a year of treatment and some talk of indefinite treatment, the jury is out.
[quote] Dr. ,

I am now into my 9th week at 40mg of Celexa, and doing considerably better than I was at previous doses (more stable, not so many swings in anxiety from day to day) and therapist says my HAM-A scores are staying at 6-7... [/quote]