How likely am I too get serotonin syndrom.

[kain]

My doctor is on vacation and took me off 40mg citalopram after 4 days because she said I wasn't showing improvement which seemed odd to me but shes the doctor right?

Been back on 30 for 2 weeks still feel awful and want to give 40mg a fair chance.

I have the script for 40mg and I want to try it a little longer or at least until I see her on the 30th.

Somebody told me I could get serotonin syndrome from increasing dose.

Ive been on citalopram for 3 years. Probably 6 months on thirty where I felt fine until the last 3 weeks.

How likely is it I will develop serotonin syndrome?

Any Advice would be appreciated.

On the 30th if im still showing no improvement she wants to go to prozac so this is citaloprams last go.

---------- Post added at 19:56 ---------- Previous post was at 18:18 ----------

Hmmmm no ideas huh. I guess I'm just going to take the 40.

[MyNameIsTerry]

Up to 40mg is the licensed dose.

Serotonin Syndrome is of little concern when on a single med, it's combinations or switches where it is more of a possibility but doctors are able to monitor for it. And SS comes in varying intensities, it's not just the worst case scenario because it can also be mild.

[panic_down_under]

My doctor is on vacation and took me off 40mg citalopram after 4 days because she said I wasn't showing improvement which seemed odd to me but shes the doctor right?

Four days is not anywhere near long enough to determine whether 40mg would work. Even 4 weeks may not be long enough.


Somebody told me I could get serotonin syndrome from increasing dose.Not from taking 40mg citalopram alone. It is rare even in massive overdoses. Are you on any other medication, including otc supplements?


How likely is it I will develop serotonin syndrome? If citalopram is all you're taking then about as likely as getting to the Moon by flapping your arms. There is more crap online and even in medical journals about serotonin syndrome that just about any other aspect of SSRIs.


On the 30th if im still showing no improvement she wants to go to prozac so this is citaloprams last go. Two weeks won't be long enough to know whether the dose increase will be effective.

Is citalopram the first antidepressant you've taken?

[kain]

Yes it is in fact the first one I've been prescribed.

At the begging they combined mirtazapine and citalopram and had horrible lucid dreams felt like I was in space ugh probably one of the worst experiences I've ever had lol.

I take 2mg klonopin a day which people keep telling me to stop taking but I don't want to rock the boat until I'm stable and when it's time to stop the kpin I'm going to do it extremely slow like I did with ativan.

And i totally agree with you but I swear in the US or Rhode island at least it is impossible to find a doctor who want to give anti deppresents more than a week to adjust.

The only reason ive stuck with this doc is overall she lets me make my own choices so if I want to stay on 40mg for a month or 2 she'll let me but she would still prefer to go to Prozac because she thinks it will help my ocd as well.

[MyNameIsTerry]

It sounds like your doctors have very little understanding of pharmacokinetics then. Basic pharmacokinetics at that.

Just stabilising your blood plasma needs to come first, real improvements can take much longer as said by PDU.

I find it's like this in the UK from most posts I see.

[panic_down_under]

I take 2mg klonopin a day which people keep telling me to stop taking but I don't want to rock the boat until I'm stable and when it's time to stop the kpin I'm going to do it extremely slow like I did with ativan.

The problem may be that the Klonopin is reducing the effectiveness of the citalopram. I'm not suggesting you quit it cold-turkey, but you should be seriously considering beginning to taper off soon. Hydroxyzine (Vistaril) might be a good substitute.


And i totally agree with you but I swear in the US or Rhode island at least it is impossible to find a doctor who want to give anti deppresents more than a week to adjust.Sigh! As Terry has already posted, it takes about a week just for plasma levels of most antidepressants to stabilize to a steady-state so what these doctors are expecting is impossible. They are effectively prescribing to the placebo effect.

The way med schools train doctors on psychiatric disorders is woefully inadequate, both in the amount of time devoted to them in the curriculum, and also what is taught. It is beyond my comprehension why this is given how many of the patients GPs/PCPs see on most days have at least one of these disorders, diagnosed, or undiagnosed, as a factor in whatever they present with. But then a lot of things about the medical profession defy my understanding.


but she would still prefer to go to Prozac because she thinks it will help my ocd as well.If OCD is a factor then either the SSRI fluvoxamine (Luvox), or the TCA clomipramine (Anafranil) would be better bets, imho, with a strong leaning toward the TCA because fluvoxamine interacts with many other medications and supplements which can complicate treatment if there are other health issues.

[kain]

Thanks for all your replies guys. I don't know if its even possible but I feel a little bit better today I know it's probably a placebo effect or maybe because I had it in my system for 4 days a week ago Idk.

I looked into Luvox it looks like it's more ocd than anxiety Prozac looks to be described for depression anxiety and ocd.

---------- Post added at 14:02 ---------- Previous post was at 11:07 ----------

I wonder if I'll start to feel a difference sooner since I've been on citalopram 3 years.

---------- Post added at 16:47 ---------- Previous post was at 14:02 ----------

Any thoughts anybody?

[panic_down_under]

I wonder if I'll start to feel a difference sooner since I've been on citalopram 3 years.

Maybe a little, but within a week is probably pushing it although antidepressants are very unpredictable meds so it isn't impossible. And if it's just placebo, well there's nothing wrong with that either. It's as good as the med driven response for as long as it lasts. Looking too deeply into gift horses' mouths can be unwise.

[kain]

I don't expect a week my friend. Rest of the day wasn't great but I'm going to just stick with it.

It's like when I get one worry out of my head I start with another like

"If this doesn't work I don't want to have to withdraw from citalopram,how dangerous is cross tapering" it just never ends my friend.