Trying to take one day at a time

[Ethansmom]

I'm on day 10 of 30mg of Celexa (started on a tiny dose 6 weeks ago). Does that mean I should start feeling better in a few weeks. My doctor said the Celexa minimum therapeutic dose is 20MG. So do the 5 weeks before this not really count?
I'm loosing my mind with the increased anxiety and have been taking Xanax three times a day due to increased anxiety. Unfortunately, the Xanax only helps a bit. I feel worse in the morning and i'm typically calmest at night.

[lior]

You should indeed start feeling better in a few weeks. Well done for bearing with the time period where you build up your dose. I felt much better on 30mg after a few weeks.

[Ethansmom]

The problem is I've been getting an increase in heart palpitations since being on the Celexa. I've noticed it's more prominent after eating. I'm scared and feel frightened of these. I just left a message for the psychiatrist.

[panic_down_under]

The problem is I've been getting an increase in heart palpitations since being on the Celexa. I've noticed it's more prominent after eating. I'm scared and feel frightened of these. I just left a message for the psychiatrist.

Everyone has heart palpitations, but most people don't notice them. We do because anxious minds tend to be more vigilant and focus on every minor physical anomaly. Palpitations also tend to be more pronounced when we're stressed.

The heart is a chaotic organ (https://www.nytimes.com/1989/01/17/science/in-heartbeat-predictability-is-worse-than-chaos.html). Beat variations are usually not significant, OTOH, a perfect unvarying heart rhythm is often a very bad sign - and before everyone starts checking their pulse, you need an ECG/EKG to determine this.

So definitely get it checked, but don't stress about it in the mean time.

[Ethansmom]

panic down under-- do you think that I would get a burst of palpitations at the same time each day if it were caused by the Celexa? Or would it be all day, everyday. I'm not sure what time the medication is released into the bloodstream. I take it at 8:30AM every morning, followed by Xanax three times a day. I'm just trying to figure out a correlation. I didn't get the palpitations when I first started the low dose 6 weeks ago. This is very recent (within the past two weeks or so).

THanks!

[panic_down_under]

do you think that I would get a burst of palpitations at the same time each day if it were caused by the Celexa?

No. Citalopram reached peak plasma levels 1-4 hours after taking a single dose, however, when taken daily for a week plasma levels stabilize to a steady-state (the drug absorption rate about equals the elimination rate) and then don't vary greatly across 24 hours.

You've mentioned the palpitations mostly occur after eating. That is more likely to be the trigger than the med. But it may also be that you've come to unconsciously associate palpitations with eating and so your mind ramps up your stress levels around meal times with the associated increase in adrenaline producing palpitations so creating a self-fulfilling prophesy.

The enteric nervous system which controls the stomach and gut may also be a factor as it is linked to the heart (also the brain and lungs) via the vagus nerves and can influence it.

[Mermaid16]

Your story is so similar to mine. I guess all we can do is take one day at a time, enjoy the good times and try to forget about the shit times. I have kind of settled on the fact that things aren't going to change anytime soon (in my situation), until I have tapered off some of the medications and started on something that will hopefully provide some reprieve. Days like today aren't so bad, the anxiety is there, but at a manageable level, yesterday was a whole other story. I know I have mentioned the ACT (acceptance and commitment therapy) before, and it is in the therapy section. Maybe if you have a read over that it may help you to change the way you view the palpitations. I, for instance, have had a tight chest today. Instead of letting it increase my anxiety, I tell myself that my chest feels tight. There is nothing I can do about it to change it, it is more than likely caused by my anxiety and just accept it. I don't always find it easy to apply the therapy, but it definately can help when I am not on high alert. Hope you start to feel better soon. Tracy xx

[Ethansmom]

Thank you panic down under and Mermaid. I find the mornings are the hardest. I am visibly shaking and feel like my mind is out of control (until I take a Xanax). Now i'm wondering if taking too much Xanax is causing the morning anxiety. I feel helpless. I'm not sure if should stick out the Celexa or try something else. I'm trying to accept that this is just the state that i'm in now and one day at a time. I did leave a message for the psychiatrist to see what she suggests. It's been 11 days on the increased dosage and feeling worse then ever :(

[panic_down_under]

Now i'm wondering if taking too much Xanax is causing the morning anxiety.

It is possible that you've become dependent on Xanax so need to take it to stop withdrawal symptoms.


It's been 11 days on the increased dosage and feeling worse then ever :(

Unfortunately, this is not uncommon. Dose increases can make things worse for a while.

[Sage579]

It can't take 2 months or more for it to reach its full benefits everyone is differnt it can take 3 months it can take 3 days don't feel bad for take the Xanax its there to help. I should have taken mine more when I started up instead of trying to tough it.

[Ethansmom]

I'm just worried that I won't know when the Celexa is working since i'm taking Xanax. Will I just wake up feeling better one day and won't need it? Panic down under--- as soon as I swallow the Xanax I stop shaking. Does this mean it's all in my head?

[panic_down_under]

as soon as I swallow the Xanax I stop shaking. Does this mean it's all in my head?

Yes. While Xanax is fast acting it still takes about 20 minutes to hit the bloodstream and an hour or two to reach maximum blood concentration.