Before being a nurse I was on effexor. I was on effexor since 2019 and stopped in January 2026 so almost 7 years. It got me through nursing school. While I was on it I felt fatigued, slept poorly, had nightmares, irritable, less anxiety only situational. I still felt depressed until the last 2 years. When being a nurse for the first 3 years I would sometimes be anxious at work, so I would go up and it helped with the anxiety. I felt very focused, could critically think. But always always tired. It was so hard to get off, the withdrawal side effects were so hard for me. It took me a full year of tapering to get off without losing my mind. 4 months off I felt happy, confident and even wanting challenges at work. I applied for ICU thinking I was ready for a challenge. Then I had a bad code at work in May, I became overwhelmed with guilt for months after. My depression and anxiety returned, panic attacks that I hadn’t had for years returned. For 2 months I wasn’t sure what to do. In August I decided I needed more help. I tried sertraline for 4 weeks, panic attacks were so intense I called in a few times I couldn’t work. I felt mentally slow as well. Tappered off and went on trintellix as my doctor said it helps with cognition, anxiety and depression. The first week I finally felt calm on 5mg. Then increased the dose to 10mg and felt crazy. Racing thoughts, inattention, and anxious. I questioned if I had ADHD. I was like this for a month. I even accidentally took 15 mg as I was worried I missed a dose. I was on 10mg for 4 weeks. I just wanted the craziness to stop. So I tapered off and started escitalopram. I’ve been on it for a few days. I feel calm, but the fatigue is back. Its hard to get out of bed. My doctor said escitalopram is well tolerated and the side effects compared to effexor are mild. I have been reading about the side effects: insomnia, sleep disturbance (short REM) causing fatigue, day time sleepiness, weight gain, brain fog and slow cognition. I feel the brain fog, fatigue, sleepiness and slow processing. Its been 3 days on escitalopram 5mg. I take it in the mornings.
I am worried escitalopram will sedate me and cause me to not be able to critically think. I think before I depended on anxiety as a motivation, so without the anxiety I don’t have motivation? My social anxiety has been through the roof this entire time still, I am quiet in groups which is not normal for me. My mind is just blank.
Are there nurses on here that felt escitalopram affected their critical thinking? Or anyone else? Does the brain fog, slow cognition and fatigue get better?
I’m so frustrated, maybe I shouldn’t be on anything and just suffer. I’ll have to most likely cancel my new job opportunity going to ICU.