How long should I give Citalopram

[Tinalou]

I suffer from recurrent bouts of depression. I stayed on a low dose of citalopram after recovering from my last episode thinking I would be able to increase it without the side effects if I started feeling low again. November last year I started upping my dose from 5 to 10 mg then 15mg. I finally saw my GP mid December who told me that I needed to be on 20mg at least as this is the therapeutic dose. I'm 8 weeks in on a therapeutic dose, I increased to 30 mg 2 weeks ago and he's told me to increase to 40 mg. But I feel no better. Anyone out there give me their advice. Should I carry on and give it longer on 40 mg?

[Tinalou]

Anyone??!!!

[panic_down_under]

I suffer from recurrent bouts of depression. I stayed on a low dose of citalopram after recovering from my last episode thinking I would be able to increase it without the side effects if I started feeling low again. November last year I started upping my dose from 5 to 10 mg

Taking low doses of any antidepressant for extended periods is very unwise. You could end up 'training' the brain to no longer respond to the med.

Antidepressants 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, not the meds directly.

There is growing evidence that antidepressants become less effective each time they are stopped and restarted. 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 drops by between 19-25% each time (see also: Amsterdam JD (http://www.ncbi.nlm.nih.gov/pubmed/18694599), 2009; Leykin Y (http://www.ncbi.nlm.nih.gov/pubmed/17469884), 2007). This applies whether returning to a previously taken antidepressant or a different one. Taking low doses may trigger a roller-coaster of neurogenesis kicking in and out, producing a similar brain response as discontinuing and restarting, but at a much higher frequency.

Once you are stabilized on an effective dose I suggest you stay on it permanently given depression is a recurring issue. I've been on above the recommended maximum doses of my antidepressants continually for almost 30 years and my brain hasn't turned to mush yet. Indeed, there is evidence they reduce the risk of Alzheimer's (http://www.biosciencetechnology.com/article/2014/05/anti-depressant-reduces-alzheimers-plaque-growth-78-percent) and other dementias (https://www.ncbi.nlm.nih.gov/pubmed/21876440)).


I'm 8 weeks in on a therapeutic dose, I increased to 30 mg 2 weeks ago and he's told me to increase to 40 mg. But I feel no better. Anyone out there give me their advice. Should I carry on and give it longer on 40 mg?

It is too early to tell if 40mg will work. It can take 2-8 weeks to get a response from a dose increase.

[Sage579]

I does take awhile for the pills to work but you have do other things as well pills are just a band aid. 8 weeks should be noticing something iv read so,e people not start to get anything till 12. If it's been helping even alil then stay on it its work it's just slow

[Tinalou]

Thank you so much for your responses xxx

[alexbro]

Most people on this forum say about 4 weeks to see results. Did your doctor tell you about the side effects, mine didn't and I got more anxious which really worried me that is why I joined this forum and every body seems to suffer the same, I am worse in the mornings, keep going and stay positive which I know isn't easy. Keep posting to let us know how you are getting on, everyone is so supportive.

[Tinalou]

Still feeling the same but going off what panic down under says I need to give up to 8 weeks on the 40mg. I am finishing work end of April due to voluntary redundancy. Been with the same employer 34 years!!!! So that probably isn't helping even though it was my decision. When I made the decision last year I was really happy. I don't want to mess with different medication in case I have to take time off work before I leave if that makes sense. I am managing to get into work at the moment (part time 3 days a week)

[beatroon]

Voluntary redundancy is very stressful and I'm not surprised you are feeling unsettled. When I went up from 30mg to 40mg, I think it took 3-6months for the full effect to come into play, at least I felt better and better - maybe that was the natural healing process though! Hang in there x

[Tinalou]

Thank you beatroon, keeping my fingers crossed it will work in time:)

[panic_down_under]

I am finishing work end of April due to voluntary redundancy. Been with the same employer 34 years!!!!

This could be the very best decision you've ever made, or among the worst. Which depends on how you - and, crucially, your significant other - plan to spend the rest of your lives, and the key word is 'plan.' Life seems to go smoother when there is a goal, even if it's to spend it on a beach somewhere drinking tequila while watching sunsets.

You may have another 34 years left. Enjoy! :D

[Tinalou]

Panic you know how to trigger anxiety!! "May be amongst the worst decisions".
My work has been the source of a lot of stress in my life so I'm hoping it's the right thing for me to do. I know it's important to have plans but difficult when anxious and depressed. When I made the decision to leave a huge weight lifted off my shoulders, that was last year in June. It's taken till end December for them to give me a date to leave, my depression started in November so I've lost my confidence. I'm probably going to look for another job NOT in a call centre.

[panic_down_under]

Panic you know how to trigger anxiety!!

I've had lots of practice. My day job was to talk softly and carry the biggest stick in the neighborhood.


I'm probably going to look for another job

Oh, I had assumed you were retiring. Seen too many do that then after a month be totally lost. It can be one of the most stressful things anyone can do...or the best thing they've ever done.


NOT in a call centre.

No wonder you're depressed. I assume you didn't do that for 34 years, but if you did your mind must have been super resilient to survive so long...or you've been nutz for a lot longer than you realise! :D

[Tinalou]

Ha ha not for 34 years. I work for a bank, a long time ago it was a great place to work.

[Tinalou]

Still feeling anxious and depressed, but husband and daughter say I seem a bit better. I really hope I am turning a corner. I really worried this will not work this time.