Does anyone use 60 mg in spite of fda warning?

[lilo]

Hi,

I would like to have some input on the following;

I am using citalopram since june this year starting at 20 mg and working my way up to 40 mg. Each time I increase I feel better for a couple of weeks and then my anxiety creeps back upon me. I am now on 40 mg since 7 weeks and I have headaches, feel brainfogged, I have teary feelings and am stressed. Did anyone experience brainfog and extreme tiredness and how long before this went away? Since each upping of the dose has helped me I am strongly thinking about upping to 60 mg especially since new trials have claimed that the fda warning has no merit and there is no solid proof that 60 mg of citalopram does cause heartfailure...and fda probably needs to revise its warnings.

Anyway does anyone have experience with 60 mg and was there any change in the brainfog or in the anxiety and teary feelings?

Does it make a difference if it is taken in the mornings or at nighttime?

Another SSRi is really no option as nothing is working. I have tried effexor which worked for 10 years and then all of a sudden stopped working. Then I switched to Prozac which was a complete drama. After Prozac I have tried sertraline and duloxetine (all dramas).

Anyone with some advice on 40 mg cit not working enough and some good advice.

I hope to hear something from someone.

[AuntieMoosie]

Firstly please DO NOT!! take yourself up to 60mgs of citalopram, those warnings weren't issued for nothing you know. I was one of the patients that had to be taken down from the 60 to the 40.

As there usually is, there may be varying opinions about this, but all the while the FDA have still got this warning "live" we must all follow it, they would have done an awful lot of research before taking that serious step.

I'm now on Sertraline which I'm finding very helpful to me, have you tried that one at all??

To be honest, I never found citalopram to be that helpful to me with my anxiety, plus it left me emotionally dead which I really didn't like. But we're all different, others, I know, find it really helpful, it's just a matter of finding the one that suits you best :)

[bethanyjay]

Hi

I have to agree with AuntieMoosie, do not up your meds without speaking to your gp, you will also find that anything above 40mg of citalopram is not a theraputic dose.

I was on 60mg and when the warning first came out about 18m ago I went to my gp, he told me just to go straight from 60mg to 40mg, I had no side effects in doing this and neither did I have any side effects going from 40mg to 60mg.

I have found now that 40mg is the dose I need to keep on a level, I have been on this dose for nearly 2 years now.

The brain fog etc could be because 40mg is to high a dose for you. Book to see your gp and they will be able to advise what is best.

Bethanyjay

[mikewales]

Apart from anything else, your GP won't prescribe you 60mg, the maximum you can get legally is 40mg

[lilo]

Dear auntymoosie,

Thanks for your extensive reply. I am going for a CBT programm tomorrow although I am not new to therapy. I have done all kinds of therapies and not new to this. The programm I am going to have an intake in tomorrow is a programm for four days a week and I really hope this is going to help me.

Furthermore I have tried almost every ssri in the book so far and nothing is doing the trick anymore. Cit was good for a couple of weeks and now slipping back in anxiety.

So that is why I posted my question. There are several articles on the internet which claim that fda warning has no merit. I am unable to post the link somehow but medscape posted it amongst other researchers.

That is why I am curious if anyone did better on 60 mg than on 40 mg. I am almost positive that my GP will prescribe 60mg because I have already discussed this with her.

Also I would like to know if it makes any difference if the cit is taken mornings or nights iro tiredness and brainfog.

Kind regards,
Lilo

[AuntieMoosie]

You're welcome :)

I must say that I am shocked to hear that your GP is prepared to prescribe you 60mg, I know that would never happen here in the UK. I can well believe that there are many sites saying many different things, this is usual path for the course with this sort of thing, but I still think that all the while this warning is live and current, we should be heeding it, but that is just my opinion on it :)

When I was on citalopram I took it in the mornings as my doctor said that I would benefit more from it that way as it helps with anxiety, but, once again, I think this is down to individual choice really, I don't think there are and hard and fast rules about it to my knowledge.

May I please ask how long you kept on the sertraline for?? Sertraline does cause a peak in anxiety when you first start taking it or if you increase your dose, but that does eventually stop and then I've always found it to be much more helpful than citalopram ever was for me, but as I've said, we're all different and I know others find citalopram really helpful to them :)

[lilo]

I took sertraline for 4 weeks and it caused me to have racing thoughts which I could not stop so I ended up in a crisis centre in which they "helped" me and transferred me to prozac which caused me a massive depression after six weeks. So my experience on all the other ssris aren't that good.

I have been on paroxetine which has helped me for 8 years then pooped out, efexor helped me for 10 years pooped out, duloxetine (for 8 hellish weeks), sertraline (for four hellish weeks), prozac (six hellish weeks) , escalitopram (caused pain in heart area)...and now on citalopram.

Citalopram is the first one I can handle although it does not quite do the job.

[AuntieMoosie]

Have you thought about trying some of the other types of anti-depressants at all??

There are many of the older type still on the market and a lot of people who can't seem to tolerate the SSRI's, have good results with these :)

[harasgenster]

I didn't know there were warnings about the 60mg dose. I used to be on 60 when I was younger but I had to be taken down because I was basically just asleep all the time. Citalopram is a serious drug and 60mg is a very serious dosage. I would make such a move your last resort if I were you.

Antidepressants are supposed to lift you enough to engage with treatment (therapy). I would push your doctors for therapy rather than upping your dose. As you've discovered, the drugs don't work for very long anyway.

Therapy wasn't useful for me for a long time because I kept being prescribed CBT. I was eventually referred 'up the scale' (in my PCT there are five stages, stage 1 being self-help and stage 5 being inpatient. If CBT is not successful you are pushed to stage 4 where you are given intensive therapy). I have been having person-centred counselling separately to schema therapy, DBT and mindfulness-based cognitive therapy. I have found this intensive approach to be extremely successful and feel better than I had since I was a pre-teen. It's quite 'academic' - involves a lot of insight, if you see what I mean - and is less focused on changing behaviour than other CBT courses, instead encouraging you to understand why you are the way you are and allowing you to decide what you would like to change. It's a very freeing process in which you are not considered to be 'ill' but instead considered to be a product of your environment. Basically, it has a lot in common with the theory behind CBT, but it takes a slightly different angle and therapies like schema and DBT tend to be longer-running than the usual 12-week treatment slot because it is assumed there are more complex things taking place that need a lot of time to work through.

If you have found yourself unable to improve with frontline CBT therapy, then you might ask about some of these other therapies. If you are not able to receive therapy for a while, then like someone above has said, a different form of antidepressant may be more helpful than a very high dose of citalopram.

[steveo]

I'd just like to point out that although I'm not on Citalopram, I'm on Escitalopram which has a dose equivalent of half the dose of Citalopram. Whilst I was in hospital I was given 30mg of Escitalopram which is 60mg of Citalopram.

The maximum dose recommended was only lowered due to a risk of QT prolongation in the heart. For most of us for short term, it's not a problem and not dangerous and picked up on an ECG.

I do agree with brain fog though. I felt like my brain had been replaced by a ball of cotton wool so I'm now on 20mg Escitalopram (same as 40mg Citalopram).

[Dbsworrier]

Ok I'm really scared. So I went to the doctors today with a view to reducing my dose of 60mg which I have been on for years. She basically said it was up to me of I wanted to go down and didn't really seem to care. Now I really wanted a definitive answer from her which I did not receive! I'm really worried due to these warnings but really don't know what to do as I have been so ill mentally recently I just want someone to tell me precisely what to do!

Any advice would be great thanks. Please keep in mind my current mental state when replying with 'you're gonna die' posts.
:(

[harasgenster]

Apart from anything else, your GP won't prescribe you 60mg, the maximum you can get legally is 40mg

When did that happen? I was put on 60mg in my early twenties.

---------- Post added at 18:56 ---------- Previous post was at 18:55 ----------


Ok I'm really scared. So I went to the doctors today with a view to reducing my dose of 60mg which I have been on for years. She basically said it was up to me of I wanted to go down and didn't really seem to care. Now I really wanted a definitive answer from her which I did not receive! I'm really worried due to these warnings but really don't know what to do as I have been so ill mentally recently I just want someone to tell me precisely what to do!

Any advice would be great thanks. Please keep in mind my current mental state when replying with 'you're gonna die' posts.
:(

I assume she means that she thinks the risk is not great enough for urgent action, but the choice is entirely yours. So, if you're so worried about it you're making yourself worse, you might choose to go on a different antidepressant. If you're feeling really bad at 60mg I would question how well the pills are working for you anyway and maybe it's worth looking for an alternative?

But I guess I'm going to say what your doctor said really - it's up to you. Maybe you could go back and ask her to give you some straight forward pros and cons which will help you make your decision.