Citalopram advice, Been on on them for 10 years

[H8CAK]

Evening all, firstly the total may be miss leading! I've suffered with depression/anxiety for around 10 years (I'm currently 39) my original symptoms were a general Ill feeling with sickness, no interest in anything and generally feeling poop! I was put on citalopram and have been on them since. I've had a few ups and downs but mainly ups. Most of my downs have been during the winter when I tend to get blips but nothing too major, it usually picks up within 2-3 weeks. I've also had a few instances when I've had a big night out on the booze and ended up being bad for a few weeks. It has always picked back up once my levels sort themselves out. The reason I'm
Posting finally after many years lurking in the background is
I've had a bit of a rough time before and over xmas with my depression/anx. This is why happened.......... during the summer I was feeling really quite good going out drinking ect. I had been forgetting to take my citalopram. I was taking it maybe once or twice a week. Obviously this wasn't the best idea and I started feeling shit around mid October. I saw the Doc and explained what I had done and he basically said I had come off the citalopram in the totally wrong way. I started back on citalopram 40mg at the end of oct and by mid/end Nov I was back to my normal self. Because of this I had a few xmas nights out which included 2 good sessions! Needless to say after the last session (2 weeks ago today) I started feeling rough again! It's gradually got worse and I feel like I'm having some of the side effects of the citalopram again with the light head, nausea and loss of appetite. My question is could me drinking heavily on 2-3 occasions close together after restarting the full dose of citalopram some how have stopped them working and now I'm suffering some of the side effects again?? The docs don't seam to be able to answer much!
After a late night convocation with my best friend who is a pharmacist he advised boosting the citalopram with a few days of 60mg. I know this was stopped in the past with heart worrys but I had previously been on 60mg for a few years.

[lostlucy]

Hiya ,

I don't really know the ins and outs but thought I would reply anyway !

So I'm quite similar I was on cit for 3 years and in the 4th year I started forgetting to take it which I think is amazing as it shows we felt strong enough and in a good place that we didn't need it anyway I was off it for 6 months went through a miscarriafe and dealt with it without the tablets but recently just hit rick bottom with panic and I have started taking them again ! X

I don't think that alcahol in relation to the meds would have an effect but I do know that alcahol is a depressant so it would change your mood for the worse ,

Keep on with the meds for a while if say , and when you start forgetting them again that's a good time to start coming off slowly x

Hope this helps somehow xx

[panic_down_under]

Most of my downs have been during the winter when I tend to get blips but nothing too major

Have you tried light therapy? If not, it may be worth a shot so ask your GP about it.


I've also had a few instances when I've had a big night out on the booze and ended up being bad for a few weeks.

While alcohol is the most widely used 'medication' in the (self) treatment of both anxiety and depression, it actually makes things worse, both in the short and long term. One of the things it does is block hippocampal neurogenesis (https://www.ncbi.nlm.nih.gov/pubmed/22906480), the mechanism by which antidepressants work (see below).


I had been forgetting to take my citalopram. I was taking it maybe once or twice a week. Obviously this wasn't the best idea and I started feeling shit around mid October.

This is a very bad idea on several levels. Antidepressants have no direct effect on anxiety, or depression in the way say aspirin has on a headache. They work by stimulating the growth of new brain cells (http://www.americanscientist.org/issues/feature/depression-and-the-birth-and-death-of-brain-cells/99999) (neurogenesis) to replace cells killed, or prevented from growing by high brain stress hormone levels. The therapeutic response is produced by these new cells and the stronger interconnections they forge. Each time you missed doses for a few days neurogenesis stopped and the positive brain changes began unravelling.

The second issue is the growing evidence that antidepressants become progressively less effective every time they are stopped and restarted, often requiring higher doses to achieve the previous level of control. Two studies, Amsterdam JD (https://www.ncbi.nlm.nih.gov/pubmed/27805299), 2016 and Amsterdam, 2009 (http://www.karger.com/Article/FullText/226611) found the likelihood of antidepressants working after each restart drops by 19-25% (see also: Amsterdam JD (http://www.ncbi.nlm.nih.gov/pubmed/18694599), 2009; Leykin Y (http://www.ncbi.nlm.nih.gov/pubmed/17469884), 2007). By taking citalopram only a few times a week you may have created the same stop/start problem.


My question is could me drinking heavily on 2-3 occasions close together after restarting the full dose of citalopram some how have stopped them working and now I'm suffering some of the side effects again??

Coupled with the haphazard way you were taking the med for a while, this is a distinct possibility.


my best friend who is a pharmacist he advised boosting the citalopram with a few days of 60mg

If you weren't living in the UK I'd be suggestion supplementing the SSRI with buspirone (Buspar). It is a Generalised Anxiety specific med which doesn't work for most, but when taken with SSRIs (and some SNRIs) it can boost their effectiveness and also restore them to full function if they have stopped working (it also eases some of their side-effects such as sexual dysfunction). However, I understand the dead hand of bureaucracy prevents NHS GPs from prescribing it for this.

Upping the dose to 60mg may trigger a response, but again, your GP probably won't/can't authorize this. I suggest you give the 40mg a few more weeks to see whether it kicks back in. If it doesn't then switching to another SSRI should help. I suggest sertraline (Zoloft).

PS: and give the booze a miss for a while. The occasional blow-out is okay, but the operative word is 'occasional'!

[RobTheRobot]

Sometimes you need to decide if getting drunk is better than your long term health.

I would booze every other weekend. Since being diagnosed with generalised anxiety and starting Cit around 6 months ago, I have had 1 drinking session.. and even that was nothing like my old booze nights.
I'm happier to stay off drink if I know it contributes to keeping anxiety away. One or two a week I'm sure is fine, but getting wrecked on a night out surely can't be good.