View Full Version : How do I get GP to prescribe Citalopram?
I've been taking Mirtazapine since April 2011 but don't feel that it works for me as my anxiety levels are high and my mood is often very low.
Before that I had been on Fluoxetine and Paroxetine, both of which seemed to do a lot better than Mirtazapine does.
So I think that SSRIs are the way forward for me. I'd like to try Citalopram but I've read on various websites the doctors are wary of patients that ask for a certain medication.
What's the best way for me to approach this situation?
I had same problem I had to be referred to the Psychiatrist by my GP , so I am on both just now only started citalopram 4 days ago and all going well with it will work down on the mirtazipine. my reasons for the change were same as yours and I had been on mirtazipine since same time. It worked fine for a while but I feel about 4 months ago a change , dont know if the med or perhaps me
I didnt even mention the med she actually did after I just expained my problems , so perhaps it is a good match
How to ask is a toughie like you say they dont like it when you self recommend perhaps just do it in a round about way , I know a friend ..... who found it beneficial ... or something
end of day same drug works differently in different people
I could say that brother suffers with depression and anxiety, and that he's found Citalopram works well for him?
nicola1980
15-02-12, 18:40
Hi ive just come onto mirtazipine from citalopram as the cit just didn't help me at all, i found it heightened my anxiety and panics no end, ive persevered with it at different doses since sept but couldn't cope anymore, i had my first appointment with a physchatrist today and shes swapped me to mirtazipine 15mg to start with xx
I found with mirtazipine nicola no side effects and straight away you will get a good nights sleep I would take it early as to start with you may find 10-12 hours of sleep and as you get used to it it eases off. Some say a little tired when they awaken but again you get used to that , I didnt consider that as a side effect really as when I started taking it I was very sleep deprived , best of luck and I hope you settle with it better.
Maybe I should just ask to be referred to p.doc? They said no last time :(
---------- Post added at 18:56 ---------- Previous post was at 18:55 ----------
Hi ive just come onto mirtazipine from citalopram as the cit just didn't help me at all, i found it heightened my anxiety and panics no end, ive persevered with it at different doses since sept but couldn't cope anymore, i had my first appointment with a physchatrist today and shes swapped me to mirtazipine 15mg to start with xx
Different drugs work differently for people Nicola, good luck with Mirt! It did work for me but I just feel flat on it these days, does nothing for my mood and anxiety. I can handle initial side effects of SSRIs, Prozac has the worst apparantly and I managed to get through that.
if you explain no longer working they have to consider an alternative , I would ask to be referred , GP's are relectant I think at times to prescribed alternate medications on mental illness patients simply I think because they feel a pyschiatrist better trained at assessing your situation etc . Nothing ventured nothing gained but they cant leave you to suffer , end of day you know your body and mind best even though at times it can be difficult to get your emotions across in words
Thanks Bignic - I'll ask to be referred when I visit :)
I hope there isn't too long a waiting time for it.
nicola1980
15-02-12, 19:11
I asked to be referred and got seen within a week by a physchatrist but i was at rock bottom so def demend a referral its your right good luck xx
Thanks Nicola, I'll definitely do that.
Hi - it is annoying when we want to be put on med and the doctor disagrees. I was put on Mirt and found it did not help my mood at all in fact in made by mood worse and anxiety. I told the doctor how I felt and said I had upsetting thoughts, etc, and when I was on Prozac, felt happier and had no funny thoughs, I asked about Citalopram and he said definitely NOT! He did mention Sertraline but we agreed to go back on Prozac - 12th day in and feeling crap but hope it will be worth it - personally prefer SSRIs for depression - hope you get sorted out and good luck - Laura :)
yes I had to wait a week too , so perhaps standard , like nicola says explain to GP you are in a desperate situation. My GP is well aware of my mental health issues have only just gotten out of hospital after a 3 month stay so my relationship with him is a very understanding and caring one.
Best of luck
nicola1980
15-02-12, 19:23
your doc might just prescribe you citalopram tho as it seems to be one of the preferred meds they try, id just ask them and if they say no then ask to be referred xx
Thanks again guys.
Laura - I agree. Mirtazapine doesn't feel like it actually does anything, sometimes I convince myself that it's just a placebo drug. The SSRIs are hard going but when they work BOY do they work - I miss feeling that euphoria and feeling that everything will be ok.
Mirtazapine just doesn't bring that - it just makes me feel groggy and emotionless.
emotionless is one of my main issues , bad enough other issues but when you feel kind of dead inside its not a good feeling , I feel at times if I could just have a good cry I would feel better , but to no avail , I feel a stranger withing the family , having a wife and 3 kids , even the kids ask their mum why is dad so quiet and not talk much , its not that I dont want to I just feel I can express emotion the way I used to , but say to myself maybe its the depression but also I ask is it the meds , some days I just feel how worse can I feel and thats taking medication hence my asking to be changed to the new citalopram.
I suffered a bad trauma 20 years ago , and was given amiltriptiline , that got back back up and running in months , Ive now nearly been out of work and had my issues for nearly a year ..
something has got to work to get me to a starting point level.
ps dont ask for amiltryptine they dont like prescribing that anymore for depression Ive been told , although I know some few GPs still do , its an old drug , I think they use it more for parkinsons disease these days
I think you can sometimes run into problems with some GPs if you ask for your current medication to be augmented by another. Although I personally have not found this to be the case.
Most GPs are usually quite willing to let you try a different medication if the current one is no longer helping. You've been on Mirt quite a while, it's not as if you've thrown in the towel in a matter of days or even weeks.
When you see your GP, try to remember that you are making a reasonable request. Maybe say something along the lines of "I've been on Mirt for quite a while, but it's no longer working that well. I've been doing a little research and I was thinking that maybe Citalopram might be the way to go - what do you think?" Suggest rather than demand, if you see what I mean... don't be the doctor. In my experience GPs are always ready to prescribe Citalopram as it works very well for most people... and it's cheap (off patent a long time). People ask for a particular medication all the time... they will be used to that.
Try not to worry too much about it. Take a deep breath.. and decide this will be the day that I ring for an appointment to sort myself out... I owe myself that much and I'm worth it.
Take care Mono.
Belle x
eight days a week
16-02-12, 00:06
I've been taking Mirtazapine since April 2011 but don't feel that it works for me as my anxiety levels are high and my mood is often very low.
Before that I had been on Fluoxetine and Paroxetine, both of which seemed to do a lot better than Mirtazapine does.
So I think that SSRIs are the way forward for me. I'd like to try Citalopram but I've read on various websites the doctors are wary of patients that ask for a certain medication.
What's the best way for me to approach this situation?
Explain this to your GP. You are articulate and reasoned, and full of insight.
If you talk to your doctor in this informed way, he or she will listen to you no doubt.
Thanks so much Belle and eight days a week - comforting words, these forums really do have some great people.
I'm off to an emergency appointment with a GP at 8am - wish me luck!
Hi Belle is right - but I am quite sure you know that Monostich - think sometimes it depends on what mood they are in (should know as work for them)! but Citalopram is a reasonable request - common and cheap and generally works well. Don't quote me but I read somewhere on this site that Mirt is made up of the same compound as Citalopram and was wondering as this is the reason my GP would not prescribe it for me? but am no chemist. As regarding augmeting antidepressants my gp said he left this to psychiastrists and did not want to go down that route - fair enough - but agree totally Monostitch - Mirt just feels like a placebo - no nasty side effects apart from drowsiness - imo should be used as a sleeping tab! Hope you get sorted out - work up this morning feeling lousy - day 12 Prozac - anxiety bad and my westie pup just wants to play! lol - take care Laura
Thanks again Laura - your input is much appreciated.
Back from the docs, I got to see a lovely (and very attractive :D) GP that I've never seen there before and she was excellent! She was very interested in my illness when in the past I've been in & out of doc's office within 5 minutes after they've thrown a prescription at me.
She has given me Citalopram and said that it's got a good success rate. 20mg a day.
I have to wean off the Mirt over the next 10 days, then I'm to take nothing for a week before starting the Cit.
I am very excited about the prospect of trying the new drug after being in this Mirtazapine fog for the last 10 months or so of my life.
nicola1980
16-02-12, 10:06
So pleased you got on ok and got prescribed cit, good luck x x
Thanks! And sorry Belle, forgot to thank you for your continued support x
nicola1980
16-02-12, 10:58
Interesting how you need to taper off and be med free before you start the cit as ive just done a straight swap from cit to mirt, just shows how diff docs work? X x
Yes it is strange. Is yours a P.Doc or regular GP?
I think I went straight from Paroxetine to Mirt but I'm not 100% sure :)
nicola1980
16-02-12, 12:01
it was a physcahtrist thats started me off on mirt and even tho id took 20mg of cit yesterday morning i was still told to take 15mg of mirt last night and then just stop the cit as of today, suppose everyone does it differently, some people even take mirt and cit together?? xx
Yeah the GPs I have spoken to at my medical centre are all frightened of 'Seratonin Syndrome' it seems and worry that if I take Cit straight away that I might 'overdose' or something?
P.Doc's much better trained to advise about matters.
Interesting how you need to taper off and be med free before you start the cit as ive just done a straight swap from cit to mirt, just shows how diff docs work? X x
Hi nicola,
I went straight onto cit next day from Doxepin, mind you i did have a bad first three days. Thought i was going out of my mind. I could have quite easily pressed the end it all button. Just as well i didnt have one. :)
good news you got your request , hope all goes well for you
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