Question: Background: Have been managing a good deal of life stress in general. Separated from husband of 20 years. Had pretty well been single parent in any case. Currently living with four teenage daughters (son moved with father.) Returned to work in crisis intervention full time. In relation to separation needed to declare personal bankruptcy. Finances obviously tight. Both parents had health crisis this past summer; trying to be available but they live two hours a way. Relationship full of painful baggage in any case. Also returned to school part time to complete MSW for professional certification. Seeing psychologist for personal support since one year. Increasingly difficult to maintain coping strategies. Sleep difficulty (not staying asleep), exercising less, gaining weight, lack of concentration and memory (including forgetting to take supplements.) Coping ok but near the edge. Have competent GP with limited imagination, but also have good private GP naturopath doctor. Not depressed as in sad or unhappy, but chronic need to keep an even keel in face of anxiety. For ten years have taken Ativan or Serax (which my GP does not believe in prescribing. So have had to get from Gynecologist, Allergist or Naturopath). At most stressful times have taken .5 Ativan (or 15mg Serax) at bedtime. Makes all the difference to feeling 'normal coping' and positive about events. Reminds me what normal feels like. However, rarely take this often. Sometimes as little as once a month, sometimes twice a week if haven't slept well in a few nights in a row. For last six months have probably used 2 - 3 times per week. (Normally try melatonin and magnesium glycenate for sleeping). Events concerning my parents in early summer overwhelmed to point of taking work leave for one week and deciding to try Cypralex in an effort to address generalized anxiety state. Took 5mg for two weeks, then 10mg for five weeks. At this time I am taking two weeks vacation. Am focussing on rest, resuming exercise regime (regular gym and Tae Kwon Do which I had let slide), eating well and establishing a constant sleep routine. I am trying, with my therapist, to prioritize my own XXXXXXX needs and resume the strategies I know help. I have established a stance I plan to take towards my parents crisis which has removed the dilemma I was faced in dealing with their choices. The Cypralex may have helped creating a certain distance 'detachment' between me and my anxiety. However, I am starting a full year of school and work ahead and do not want the foggy head I am feeling. Before I go further down the road of Cypralex I would like to stop. I am feeling with the changes in attitude that I am taking -- that I can resume coping in a more positive way. I advise people re antidepressants in my work all the time but it is amazing how unclear it becomes when it is oneself. Question: After taking Cypralex for only seven weeks -- how quickly can I reduce or go off it? How long might I expect side effects? (Most side effects going on were: headache, sinus irritation, foggy sense of detachment.) For me, taking a Serax as needed seems a feasible plan of action.)

Thank you. Tapering the Cypralex over a week is do able. Wasn't sure how long seemed reasonable, especially given the short time I took Cypralex. Follow up question: Does it seem reasonable to take a Serax or Ativan occasionally as an anxiety strategy? (My own GP is very reluctant - but I know other doctor's are more comfortable with this.) I do not have an addictive nature regarding any substance. Quit smoking 17 years ago, never drank much and don't even drink coffee or tea. With five teenage children, aging parents, working full time and going to school while navigating an ex spouse to keep the peace, being 54 and post menopausal -- it doesn't seem to me like a surplus of anxiety is very unexpected. I practice meditation and have a rich spiritual life as well. Taking an antianxiety medication from a few times a week to occasionally to ensure a good nights sleep does not seem an unreasonable support tool to me. What do you think?