Side effects with increase - Help!

[MarlaJ]

I am on day 11 of this terrible journey. This is my third go round, and it is so much worse than the last two. I tried tapering up to avoid side effects, 4 days at 5mg, now 7 at 10. Terrible morning panic, some calm bits during the afternoon, and terrible anxiety in the evening. I saw the doc, and he has given me Ativan to help through, and really wants me to get to 20mg asap.

Two things, he seems quite shocked and unconvinced that the anxiety and panic are due to the meds. I am sure they are. When I approached him to go back on I wasn't a soggy mess. I had noticed over the last few months that I was slipping back to anxious ways - looping thoughts, found it was taking a huge amount of energy to get through a day, wanting to disconnect from the world more and more. Now I am a jittery mess. I have difficulty facing each morning, I wake up at 5am in full panic, jittery, sweaty, and want to cry. The thought loops have all turned to gloom and desperation, & I feel like I am totally going out of my mind. I am convinced it is the citalopram. Why does the doctor seem so shocked, when there are so many others on here describing exactly what I am going through?

Second, if I increase my dosage, how much worse, and for how long can I expect these "side effects" to continue? I'm not sure how much worse I can feel and still be able to function ::

[raindeer]

They gradually go away, if you dont actually need the meds, dont take them. If you cant do without them, ask for a increase in dosage. Give it like 1-8 weeks. All those symptoms you described, I went through them and and almost fine now. The anxiety and panic are most def due to the meds.

As far as the time period goes, really it depends upon many things. I say 1-8 weeks is reasonable. Also, try changing your surroundings, that helped me more than the meds to be honest, thats how I am off them.

[MyNameIsTerry]

He sounds like a doctor with less experience of these meds. Increased anxiety is one of the most common side effects of SSRI's and it says this in all the literature including the leaflet in the box so there is really no excuse for a doctor not to know that other than having little training & experience in them...either that or he refuses to believe the rest of the medical world! How he can be shocked just baffles me, it's one of the most common side effects.

It takes 5x the half life of a drug for it to reach "steady-state" in your blood plasma. So, for your med it's 5 x 36hrs (half life) = 180hrs. Thats 7.5 days. "Steady state" means as much going in and coming out. So, perhaps get your blood in this state first before adjusting doses and it might help otherwise you are continually trying to get your blood to adjust. This a standard pharacokinetic calculation for drugs in the human body and it differs based on many factors so can never truelly be calculated for the individual e.g. renal function impacts on it, slow or fast metabolism, etc.

As you increase, it could mean more of the same, it's hard to say. From some other people on here who started at 10mg, they felt it more at 20mg, but everyone is different. If it's really hard, you could try going to 15mg and see if it gets worse and make a decision from there.

Side effects can be 4-6 weeks for some and less for others. I found on this med that the first week or so was the hardest and by week 3 it had reduced a fair bit. The thing is though, some people can't tolerate certain meds and switch to another to find it easier so if it becomes completely unbearable, you could opt for this BUT it's very much a lottery with this and you could experience the same or similiar issues so try to be realistic about it. I know it's hard, I've been through it twice now, once getting onto Citalopram, and the current one, Duloxetine. I struggled badly with starting both. Hang in there.