Anxiety, no focus, exams coming up....restart Citalopram?

[asf259]

Dear all,

I have some important resit exams coming up at the end of September and I'm really struggling with staying focussed and my concentration seems at rock bottom. I'm struggling retaining and recalling info and am getting really anxious because this is my last attempt at staying on in this course. I had to wait a year for university appeals to go through and to get this one chance, so the stakes are really high...but I just can't shake off these feelings of helplessness and just hunker down to the books. I'm trying to get up and go to the library etc, but end up just feeling really drained and staying in bed.



I messed up my exams in June '12, which was my 7th month of restarting Fluoxetine 40mg. I spent the months leading to the exams oversleeping and being nocturnal. I'd spend upto 15hrs a day asleep, despite my best efforts, missed morning lectures and in the exam period I ended up studying through the night, going in for the exam, then coming back and sleeping. Because of this routine, I also ended up missing an exam.

Since then I was prescribed Citalopram 20mg which I took regularly till Sep '12, when I was informed that I would not be allowed to sit the resits. Then started a long appeal process against the Uni during which I got even more desperate and dejected. I stopped taking the meds out of frustration, but did start some CBT sessions. CBT helped me learn to stop catastrophising and understand how to try and stop the negative thought cycles, but I still struggle to put it to practise sometimes.

This is all on a background of a previous depressive episode that lasted a few years ('04-'07). I was then okay for a couple of years until my marriage collapsed at the end of '10.



Right now, I am getting really desperate. I'm wasting days not being productive and getting frustrated at how low I'm feeling. I keep being reminded of how high the stakes are, and if I fail these exams again I really don't know what I would do. I'm considering restarting Citalopram, but I am worried about the adverse effects it has on concentration and if my sleep issues just return just like last June.

I need something to just give me a boost, a kick-start so I can stop feeling sorry for myself and get proactive. No amount of coffee or cigarettes are helping. My biggest worry is that if I start something new, the number of weeks they tend to take for the full therapeutic levels to be reached will mean I won't have much time before the exams. I'm also worried about being told off by my GP for stopping the Citalopram.

I realise this has become quite a long post, but I would appreciate any advice or recommendations anyone can provide.

[Sparkle1984]

Hi, sorry to hear you're struggling. I'm on citalopram 20mg myself. Are you saying you came off them last September because they were affecting your ability to concentrate on your studying? If so, maybe you could ask your doctor if you could try something else instead. I'm sure your GP won't tell you off - lots of people have to go back on meds a second time (it's actually my second time), and there are people on this forum who have been on and off them loads of times.

Is your university aware that you're struggling? Most universities have a student support service, so if you tell them (if you haven't done so already) they could give you some advice and support with your studies.

[asf259]

Thanks a lot for taking the time to reply, really appreciate it.

I stopped taking them religiously from September when I found out I was denied permission to resit. I then lost hope completely and stopped taking them in January.

I guess I'll make an appointment with my GP...I'm quite worried about trying new meds though...it took me a lot of reading around to be happy with the Flux --> Cit switch. In my previous depressive episode, I started on Paroxetine, then went on Venlafaxine, that gave me a lot of hyper episodes so I was put on Valproic acid alongside it before stopping both and settling on Fluoxetine. Needless-to-say, those years were terrible until Flux. But this time round, the oversleeping was the biggest issue when I started Flux, back at the same dose as before.

My college at university is supposed to provide help and support in these situations, but they were the ones who weren't in favour of me resitting in the first place. It's because of them I had to go through several appeals with the higher university bodies. I think I've exhausted any support I can get from uni.

[asf259]

I started taking 10mg (in the mornings) from the 13th (I had some left over from before), so it's been 5 days. (I wrote the original post last week but didnt bring myself to post it). Went to my GP yesterday evening who gave the normal advice of giving it a couple of weeks for the full effects, I mentioned the dazed-out feeling I was having while on it, but that I was being more productive.

But now I am getting intense feelings of anxiety and feeling really on edge. I can't focus on anything because I'm overly buzzed up. Not sleeping well either and am really really scared I won't get enough revision done in this state.

I read around a bit and there are various accounts of taking upto 4 weeks for these negative effects to diminish. I know responses to AD are specific to the individual, but at this rate I really can't afford to waste time feeling like this.

I realise I should not have ever stopped taking them in Jan whilst my appeal was going through...it would have given me enough time to have stabilised in time for now, but at that time whether or not I'd be allowed to resit was a big uncertainty.

What should I do? I think I've reached a point of no return....should I carry on taking them or stop and battle through the low motivation?

[Emphyrio]

Why not start at 5mg and work up? I've been taking 5mg of citalopram, which has made a difference to anxiety and depression, though in my case its because I'm very sensitive to medication.

Once you're stabilised, there are several ways you can gain more focus. Try something like L-Tyrosine or DL-Phenylalanine, which can be bought cheaply from Holland and Barrett. Essentially, they work as a precursor to dopamine and norephinephrine - which are associated with motivation and focus.

Rhodiola Rosea is another possible supplement you could try, although there are conflicting reports as to whether you should take them with SSRIs - I would have a read of experiences etc if you do decide to give it a try.

[asf259]

Thanks for your reply.

I figured since 10mg is the lowest recommended dose, anything lower would be nearly homeopathic. But I'll try what you advised....just got hold of a pill cutter.

Thanks for opening my eyes to those, it never occurred to me that they would be available OTC. I had a read around about DLPA & LTyr then ventured onto all sorts of nootropic forums discussing them. My only concern is that when I was on an SNRI it triggered intense mania. Although the two are only precursors as opposed to inhibiting reuptake, I'm worried the net increase in norad would tip me that way again.

[asf259]

The GP increased my dose to 20mg yesterday. I hope the side effects aren't as bad as when I started the 10. I'm worried it's going to increase my sleep like the Fluoxetine did last year. Right now I'm going on 5-7hrs but am tired throughout the day and no amount of coffee seems to help.

I feel a bit more motivated, but my focus is all over the place. I keep getting distracted, even though I've cleared my desk and am trying to study in a quiet room. I still wake up with panic attacks and it takes about half an hour of breathing exercises to calm down. There are times when I feel quite dizzy too. I hope these will wear off.

I'm getting so worried that I only have 2 months left and it's just not going to be enough time to cover everything and pass. I'm trying to go through past papers and be selective with my revision but the stakes are so high and I'm really on edge.

[asf259]

I've continued taking the citalopram at 20mg but have struggled with constant highs and lows on a daily basis. When I feel low, I just want to escape my situation and end up putting some music on or sleeping. When I feel high, I tried to study but my mind would wander and I would get so easily distracted. I've tried to push through as best I could, but it has been too little too late.

My finances have been terrible, so I have had to carry on working a couple of night shifts a week to tide things over, which would disrupt my routine. I've been worried over my parents' health, both of whom live abroad in two different countries and I am stuck here not being able to help either of them.

What is wrong with me? This was my last chance and I have messed it up again. What worries me more is that I don't feel anxious or nervous about this situation...just numb and apathetic.